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Opinion Plain cigarette packaging can save lives – we need to introduce it in Ireland

Plain packing would both reduce the level of consumption in current smokers AND discourage young people from starting in the first place.

SMOKING CURRENTLY COSTS the Irish taxpayer between €1 and €2 billion a year to provide health services to smokers. But behind the financial cost is the human cost, with an estimated 5,500 people a year dying from smoking-related diseases and many more suffering from conditions caused by smoking.

As one of his last acts as Health Minister, Dr James Reilly introduced the Public Health (Standardised Packaging of Tobacco) Bill, which will introduce standardised, plain cigarette packaging as part of his goal to make Ireland a smoke free country by 2025. A rather admirable albeit naïve objective. Although this lofty goal may not be reached, any measure to reduce the level of smoking in Ireland is most welcome.

Plain cigarette packaging has thus far only been introduced in one country worldwide, Australia, where cigarettes are now sold in plain, olive-coloured packaging, in same-size boxes with uniform typeface and large health warnings. Due to the limited application of plain packaging there is little concrete evidence to attest its efficacy.

Branding matters

However, there have been over two dozen peer-reviewed studies which suggest that branding encourages youth uptake of smoking. Experiments were also conducted with plain cigarette packaging and they yielded some interesting findings. Not only did smokers deem the packaging less attractive but they judged the taste to be inferior even though it was the same quality tobacco. Plain packaging also increased negative perceptions about smoking. Many resorted to hiding the packet and reduced their consumption while in public.

Cancer Council Australia comprehensively reviewed the evidence in relation to plain packaging:

The evidence indicates three primary benefits of plain packaging: increasing the effectiveness of health warnings, reducing false health beliefs about cigarettes, and reducing brand appeal especially among youth and young adults. Overall, the research to date suggests that ‘plain’ packaging regulations would be an effective tobacco control measure, particularly in jurisdictions with comprehensive restrictions on other forms of marketing.

Ireland is one such jurisdiction. Tobacco advertising is banned on TV, billboards and radio. Even in-store advertising and displays are no longer permitted. In such a heavily restricted environment, packaging becomes the sole vehicle for communicating brand image and to promote the product. By introducing plain packaging it denies tobacco companies their final avenue for advertisement.

The tobacco industry

Since the inauguration of Australia’s plain packaging laws, the tobacco industry has claimed its sale of cigarettes increased by 59 million sticks in the first year of the policy. This translates to a 0.3% increase in sales. Although 0.3% doesn’t sound significant, it comes after a 15.6% decrease in sales in the previous four years. However, these statistics emanate from the tobacco industry which obviously has a conflict of interest.

The tobacco industry has been putting up a ferocious fight to combat plain packaging, including media campaigns and legal challenges. A negative portrayal of plain packaging laws would be to its benefit, not only in terms of helping to repeal the Australian law but also in preventing others nation’s enacting similar legislation. Thus the report suggesting an increase in sales should be taken with a pinch of salt, especially since the report has not been made accessible to the public, preventing it from being independently verified. Also, if it were true that sales had increased then, surely, the tobacco industry would cease their fervent opposition to a policy which they claim they are profiting from.

Further eyebrows are raised as the Australian Bureau of Statistics national accounts show that the consumption of tobacco and cigarettes during the March quarter of 2014 is the lowest since records began in 1959. This has been corroborated by the National Drugs Strategy Household Survey which, in a recently released report, found that the daily smoking rate plunged from 15.1% to 12.8% between 2012 and 2013. More encouragingly it found that 95% of 12 to 17 year olds have never smoked.

Plain packaging will assist in the decline of cigarette consumption

The importance of evidence-based policy making, especially in regard to health, cannot be overstated. It is paramount that all decisions are based on accurate and meaningful information to ensure effective outcomes. Both the scientific studies and the data provided by the Australian Bureau of Statistics and National Drugs Strategy Household Survey suggest plain packaging, combined with previously established measures, aid in reducing the consumption of tobacco and cigarettes.

Although the policy is in its infancy and it will take a few years before definitive, longitudinal data can be extrapolated, based on the current available evidence the introduction of plain packaging will assist in the decline of cigarette consumption and the government should proceed with the policy.

Not only will it help reduce the level of consumption in current smokers but it will also discourage young people from adopting the habit. This will decrease the financial burden on the taxpayer but, more importantly, prevent many people from dying from smoking-related illnesses.

Decreasing the levels of smoking in Ireland is a worthy goal and plain cigarette packaging is demonstrable method of doing so, its introduction should be welcomed.

Peter Ferguson is a sceptic and a writer, he is a contributing author in the upcoming book 13 Reasons to Doubt, and he blogs at SkepticInk.com. Twitter @humanisticus

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64 Comments
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    Mute Bazalini
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    Nov 29th 2014, 10:10 AM

    Good luck to her. Hopefully some of the other finalists get a chance to launch their ideas as well

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    Mute Patrick
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    Nov 29th 2014, 7:14 PM

    It must be awkward carrying that big phone.

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    Mute Ignoreland
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    Nov 29th 2014, 10:22 AM

    People tend to use the same GP because patient history is one of the most important diagnostic elements. Will this be a problem for her model?
    It maybe I’ve just been watching too much House…

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    Mute Derek Cregan
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    Nov 29th 2014, 10:39 AM

    Ignoreland…..perhaps the patients history could be put into a database and be accessed by the patient using a P.I.N?

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    Mute Tracey Nally
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    Nov 29th 2014, 12:39 PM

    For a country the size of Ireland, it should be possible to network the whole system. If I have an injury in donegal then it should be possible for them to access my records even though I’m based in the Midlands.
    Email should be a given instead of slow mail when gp’s are writing a referral. Plus text message reminders for out patient appointments.

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    Mute David Burke
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    Nov 29th 2014, 4:49 PM

    It’s more complicated than you would imagine to have digital health records.

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    Mute Lastpost
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    Nov 29th 2014, 10:13 AM

    Way to go girl, good on you great idea

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    Mute Sarah Butler
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    Nov 29th 2014, 10:29 AM

    Well done to her. I hope she focuses on Ireland though, not just Dublin.

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    Mute Kerry Mink
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    Nov 29th 2014, 11:15 AM

    Best idea I’ve heard of since Google! Go girl!

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    Mute Alan Moore
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    Nov 29th 2014, 1:10 PM

    Who gives out these awards? No website, no App, only an idea. This idea will die in the crib. Taxi drivers in UK are trying to make Uber and Halo illegal. Trying to do the same thing in the medical industry (a hugely regulated industry with powerful unions) is stupid. This lady will be eaten for breakfast. Might work in medical areas that are not regulated, like Chinese medicine. Saying “you go girl” without thinking critically about the idea is really patronising to her.

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    Mute Alan Moore
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    Nov 29th 2014, 1:57 PM

    Don’t get me wrong, I wish we lived in a world where this app would be successful. I am no lover of unions and government regulations, but a business has to work in the real world

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    Mute Paudi Onail
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    Nov 29th 2014, 3:22 PM

    i think the idea of the compeition is to win funds to develop,test, launch so those end user products will come. never put the cart before the horse. having an app and a website before having a solid idea with promise never really works, your app and website just sits there doing nothing. i’m sure she has a rough visual prototype, presentation etc of how it works to pitch with.

    having said that, i do see problems with the idea itself. GPs as we all know are expensive, “more business for GPs” – cry me a river, canceled appointments is of no loss to GPs, patients reschedule and in many cases theres a cancel fee. Would it mean triple travel expenses for call out fees? A travel expense in GPs terms could be a taxi fare x 3. There are approx 2million medical and GP-visit cards in use here as well. How does it cater for them, and with regarding travel fees. I don’t think the HSE will pay for it no more than old age free travel covers taxi fares. So, back to private customers. If they can afford it then great then thats her target market. I think the fees involved, how many ‘private users’ will sign up for it and of course access to medical records, data security and release of said data would ideas for the app to overcome.

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    Mute Patrick
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    Nov 29th 2014, 7:15 PM

    @Alan From an acorn can grow a mighty oak. Ideas are everything.

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    Mute Alan Moore
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    Nov 29th 2014, 8:14 PM

    @patrick, ideas and nothing, implementation is everything. Google didn’t come up with the idea of a search engine, Microsoft didn’t come up with the idea of a computer operating system. Implementation is everything

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    Mute Peter McGlynn
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    Nov 29th 2014, 11:18 AM

    We need the same for Doctors. I couldn’t even find a reliable site by googling. Doctor app please together with consultancy fee. Thank you.

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    Mute Karl Neff
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    Nov 29th 2014, 7:29 PM

    Good luck to her. I hope that this proposed alternative delivery of healthcare is not a platform for inexperienced professionals (who can’t work in the health system due to recruitment embargo of past few years) to get work. My issue with this is that for some patients who are vulnerable – they may be paying for a service that isn’t top quality. Finally, I look forward to the other 23 applicants proposals to be reported by the journal.

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    Mute Rory J Leonard
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    Nov 29th 2014, 11:58 AM

    This young lady and her ingenious click clinic app has possibly doubled or trebled the market for the medical professionals offering those services.

    Disruptive technology at its most effective!

    Well done to her!

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    Mute Steve Tracey
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    Nov 29th 2014, 12:43 PM

    Good on ye lass hope it gets taken on.

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    Mute Sam McAllister
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    Nov 29th 2014, 1:01 PM

    Is disruptive the new “in-word”?

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    Mute Robert Caraher
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    Nov 29th 2014, 11:49 PM

    Have seen this of Twitter and as a fellow physio I see flaws in the business model!! Already websites like what clinic and generally find its more cost effective to invest in google Seo on our own website! But u know what folks fair play to her she is pushing an idea she has into reality!! How many of us have had ideas and never done anything about them!!! My wee bit of advice if the young lady does read this is under promise and over deliver!!

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    Mute Mary Moore
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    Nov 30th 2014, 1:42 AM

    I always worry when I see words like ‘entrepreneur’ and ‘health’ used in the same sentence. That immediately puts me off. But good luck to her and the others too with their inventions.

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    Mute Telbar Comuta
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    Nov 30th 2014, 3:53 PM

    Unfortunately it’s a zero sum game. There will always be people waiting as long as the health service is understaffed. In fact, it seems unfair that the young tech-savvy people with the app are going to get treatment faster than, and possibly at the expense of, the older people

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    Mute Brighid Sheridan
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    Nov 30th 2014, 2:20 PM

    Well done and best of luck with the idea!

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