Consumer Perceptions of Cigarette Design in France: A Comparison of Regular, Slim, Pink and Plain Cigarettes

INTRODUCTION

The cigarette, like the cigarette pack, is used by tobacco companies as a promotional tool. We explore how the cigarette could potentially be used as a dissuasive tool.

METHODS

An online survey was conducted with 15-30-year-old smokers and nonsmokers (N = 998) in France to explore their perceptions of a plain cigarette (gray with no brand name) and three branded cigarettes (regular, slim, pink). Participants were randomly assigned to view the plain cigarette and either the regular, slim, or pink cigarette. They were asked to rate the cigarettes by Appeal (tastiest, highest quality, and most expensive), Harm (most dangerous and most effective for motivating people to talk about tobacco dangers), and Perceived behavioral impact (most effective to convince teenagers not to start and to motivate smokers to reduce consumption and quit).

RESULTS

In comparison to the gray cigarette, each of the branded cigarettes were considered more appealing, less harmful, and more likely to motivate teenagers to start and less likely to motivate smokers to reduce consumption or quit.

CONCLUSIONS

The study suggests that altering the appearance of the cigarette may reduce cigarette appeal, increase harm perceptions, and deter both young people and smokers.

IMPLICATIONS

Very little research has focused on dissuasive cigarettes whereas the cigarette stick has become very important for tobacco companies for communication purposes. This is the first study to compare the effect of various branded cigarettes (regular, slim, and pink) with a plain gray cigarette on young adult smokers and nonsmokers. The findings suggest that a plain gray cigarette can reduce cigarette appeal, increase perceptions of harm, and may deter use among both smokers and nonsmokers.

Using Neuroscience to Inform Tobacco Control Policy

INTRODUCTION

Techniques employed in the field of neuroscience, such as eye tracking, electroencephalography, and functional magnetic resonance imaging, have been important in informing our understanding of the cognitive mechanisms underlying tobacco smoking. These techniques are now increasingly being used to investigate the likely impact of tobacco control policies.

AIMS AND METHODS

In this narrative review, we outline the value of these methodological approaches in answering policy-relevant tobacco control research questions, with a particular focus on their use in examining the impact of standardized cigarette packaging and health warnings. We also examine the limitations of these methodologies and provide examples of how they can be used to answer other policy-relevant questions.

RESULTS

We argue that neuroscience techniques can provide more objective evidence of the impacts of policy measures, allow investigation where it is not possible to conduct behavioral manipulations, and facilitate a deeper understanding of the cognitive mechanisms underlying the impacts of tobacco control policies such as standardized packaging, health warnings, point-of-sale displays, and mass media campaigns.

CONCLUSIONS

Rather than replacing more traditional methods of examining tobacco control measures, such as observational experiments, surveys, and questionnaires, neuroscience techniques can complement and extend these methods.

IMPLICATIONS

Neuroscience techniques facilitate objective examination of the mechanisms underlying the impacts of tobacco control measures. These techniques can therefore complement and extend other methodologies typically used in this field, such as observational experiments, surveys, and questionnaires.

Tobacco industry's elaborate attempts to control a global track and trace system and fundamentally undermine the Illicit Trade Protocol

BACKGROUND

The Illicit Trade Protocol (ITP) requires a global track and trace (T&T) system to reduce tobacco smuggling. Given the tobacco industry's (TI) historical involvement in tobacco smuggling, it stipulates that T&T 'shall not be performed by or delegated to the tobacco industry'. This paper explores the rationale for & nature of the TI's effors to influence the ITP & its T&T system.

METHODS

Analysis of leaked TI documents and publicly available data; ,investigation of front groups, trademark and patent ownership.

FINDINGS

Growing & diverse sources of evidence indicate that the TI remains involved in tobacco smuggling and that TI cigarettes account for around two-thirds of the illicit cigarette market. The TI therefore has a vested interest in controlling the global T&T system aimed to curtail this behaviour. To this end, Philip Morris International (PMI) adapted its pack marker system, Codentify, to meet T&T requirements, licensed it for free to its three major competitors who then collectively promoted it to governments using front groups and third parties including companies claiming to be independent despite clear TI links. PMI also sought to suggest Codentify was independent by selling some parts of its intellectual property on Codentify while retaining others, leaving a complex web of shared interests. In Africa, British American Tobacco used payments to obtain data suggesting its smaller competitor companies were evading taxes and secure influence with tax authorities. Regulatory capture has been enhanced by a public relations effort involving TI funding for conferences, training, research, and international police and anti-corruption organisations. Collectively this has created public messaging and a powerful network of organisations supportive of the TI's misleading postion on illicit.

CONCLUSIONS

Governments should assume the TI seeks to control T&T systems in order to avoid scrutiny and minimise excise tax payments and that any T&T system based on Codentify, on intellectual property currently or previously owned by the TI, or being promoted or implemented by companies with TI links, is incompatible with the ITP and would not serve to reduce illicit trade.

Reducing levels of medical device contamination through package redesign and opening technique

Objectives

The goal of this research was to evaluate how material curl, package structure and handling of pouches containing medical devices affect rates of contact between non-sterile surfaces and sterile devices during aseptic transfer.

Methods

One hundred and thirty-six individuals with practical experience in aseptic technique were recruited. Participants were asked to present the contents of four different pouch designs (a standard, one designed to curl in, another to curl out and one that incorporated a tab) using two transfer techniques. During the first block of trials “standard technique” was used; participants presented using their typical methods to the sterile field. Trials in the second block employed “modified technique”; participants were instructed to grab the package at the top center and present package contents using a single, fluid motion. The outside of the pouch and the backs of the participants’ hands were coated using a simulated contaminant before each trial. The simulant was undetectable in the visible spectrum, but fluoresced under a black light. The dependent variable was recorded in a binary fashion and analyzed using a generalized linear mixed model.

Results

Participants were between 20–57 and the averaged year 5.1 years of experience in aseptic technique. The data analysis was based on generalized linear mixed effects (GLMM) model, which accommodates the repeated measurements within the same participant. The effect of the pouch design was significant (P‹0.001), but the effect of aseptic technique did not suggest significance (P = 0.088). Specifically, pouches designed with the material curled outward resulted in significantly fewer contacts with non-sterile surfaces than the other styles, including the inward, tab, and standard styles; this was true regardless of the used aseptic technique, standard (P = 0.0171, P = 0.0466, P = 0.0061, respectively) or modified (P‹0.0001 for all comparisons)).

Conclusion

Results presented here contribute to a growing body of knowledge that investigates packaging as a potential route of contamination for sterile devices during aseptic presentation. Specifically, we provide insights regarding how both package design and opening technique can be informed in ways that build safety into the healthcare system.

How effective is the plain packaging of tobacco policy on rates of intention to quit smoking and changing attitudes to smoking?

BACKGROUND

The aim of this study is to critically appraise the evidence for the effectiveness of the plain packaging of tobacco products policy.

METHODS

A systematic approach to a literature review was undertaken using five databases: PubMed, MEDLINE, Google Scholar, Global Health and Legacy Tobacco Documents Library. Quantitative and qualitative studies that evaluate attitudes towards smoking, starting smoking and quitting intentions when plain packaging use is compared with standard cigarette packaging use were included.

RESULTS

A total of 1923 studies were identified. After inclusion and exclusion criteria were applied, nine studies were included in the review. The overall quality of the data was variable but a significant number of the studies had major methodological flaws. However, data analysed in the literature review suggest that exposure to plain packaging increases intention to quit amongst exposed individuals, increases negative attitudes to both smoking and starting smoking.

CONCLUSION

Although the evidence for plain packaging of tobacco is not strong, the evidence that is available indicates that it is an effective tobacco cessation policy.

The Power of Product Innovation: Smokers' Perceptions of Capsule Cigarettes

Introduction

Since being brought to market in 2007, cigarettes with capsules in the filter that can be burst to change the flavor have had remarkable global success, highlighting the importance of product innovation for tobacco companies. Very few studies have explored how these products are perceived by smokers however. This paper sought to address this gap by exploring smokers' awareness of cigarettes with one or two flavor-changing capsules in the filter and the appeal of these products.

Methods

Twenty focus groups were conducted in Glasgow and Edinburgh in 2015 with current smokers (N = 120), segmented by age (16-17, 18-24, 25-35, 36-50, >50), gender, and social grade.

Results

Awareness, use and appeal of capsule cigarettes was greater among younger adults (16-35 years), who showed most interest in these products. Those who perceived capsules positively mentioned multiple benefits: the ability to burst the capsule, convenience of being able to share cigarettes among menthol and nonmenthol smokers, better taste, fresher breath, reduced smell, and greater discretion. It was suggested that capsule cigarettes, particularly the double capsule cigarette (which had two differently flavored capsules in the filter), would encourage nonsmokers to experiment with smoking and discourage smokers from quitting.

Conclusions

The findings offer some reasons behind the global growth of the capsule cigarette segment.

Implications

Cigarettes with flavor-changing capsules in the filter have been one of the most successful product innovations of the last decade for tobacco companies. They have received very little academic attention however. Employing focus groups with 120 smokers aged 16 and over, we found that capsule cigarettes held most appeal to, and were considered to be targeted at, younger people, with it suggested that these products would encourage initiation and discourage cessation. This study provides some understanding of how these products are viewed by smokers.

Low-Dose Irradiation With Modified Atmosphere Packaging for Mango Against the Oriental Fruit Fly (Diptera: Tephritidae)

Irradiation is used to disinfest the oriental fruit fly, Bactrocera dorsalis (Hendel) (Diptera: Tephritidae) and other pests on mango fruits before export from Thailand to foreign markets. Modified atmosphere packaging (MAP) used during export of mangoes creates a low-oxygen environment that may reduce the efficacy of quarantine irradiation treatment against B. dorsalis. 'Nam Dok Mai' mangoes infested with third-instar larvae of B. dorsalis, wrapped with three different kinds of MAP bags (CF1, FF5, and H34M) or no MAP, were treated with gamma radiation at 0 (control), 30, 60, 90, 120, and 150 Gy. The average O2 and CO2 concentrations in MAP bags with mangos were 7.2 and 8.7% in the H34M bag, 8.6 and 21.2% in the CF1 bag, and 9.6 and 26.7% in the FF5 bag, respectively. The use of MAP on infested mangoes significantly increased mortality of B. dorsalis under irradiation treatment. The estimated lethal doses to cause 99% mortality (LD99) for no MAP and MAP (CF1, FF5, and H34M bags) treatments were 58.1, 41.6, 43.8, and 47.4 Gy, respectively. Therefore, MAP acted as an additional stressor rather than providing radioprotection in irradiated B. dorsalis. Large-scale confirmatory testing of 35,000 B. dorsalis larvae treated at a radiation dose of 150 Gy in mangoes with H34M MAP bags produced no survivors to the adult stage. Commercial use of MAP producing the O2 levels that we observed for mangos in this study will not reduce the efficacy of the approved 150 Gy quarantine irradiation treatment for B. dorsalis.

Effect of Low-Oxygen Conditions Created by Modified Atmosphere Packaging on Radiation Tolerance in Drosophila suzukii (Diptera: Drosophilidae) in Sweet Cherries

Modified atmosphere packaging (MAP) creates a low-oxygen (O2) environment that can increase the shelf life of fresh produce by decreasing respiration and the growth of pathogens. Low oxygen may also increase insect tolerance to irradiation (IR), and the use of MAP with products treated by IR to control quarantine pests before export may inadvertently compromise treatment efficacy. Spotted wing drosophila, Drosophila suzukii Matsumura (Diptera: Drosophilidae) is a quarantine pest of stone and small fruits and a potential target for postharvest IR treatment. The effect of low oxygen generated by MAP at ambient temperatures on the radiation tolerance of D. suzukii infesting sweet cherries was examined. Early pupal stage D. suzukii were inserted into ripe sweet cherries and treated by 1) MAP + IR, 2) IR alone, 3) MAP alone, or 4) no MAP and no IR and held for adult emergence. Three types of commercially available MAP products were tested that produced different oxygen concentrations between 3 and 15%, and a sublethal radiation dose (60 Gy) was used to allow comparisons between the treatments. Xtend PP61 bags (3.2-4.8% O2), Xtend PP71 bags (5.4-8.6% O2), and Xtend PP53 bags (13.6-15.4% O2) did not enhance survivorship to the adult stage in D. suzukii pupae irradiated at 60 Gy in sweet cherries. MAP use should not compromise phytosanitary IR treatment against D. suzukii in exported sweet cherries or other fruit.

Adult smokers' perceptions of cigarette pack inserts promoting cessation: a focus group study

INTRODUCTION

Tobacco companies have a long tradition of including promotional material within cigarette packs, such as cigarette cards and coupons. Only in Canada are they required, by the government, to include educational material within cigarette packs, in the form of inserts highlighting the benefits of quitting or providing tips on how to do so.

METHODS

Twenty focus groups were conducted in Glasgow and Edinburgh in 2015, with smokers (n=120) segmented by age (16-17, 18-24, 25-35, 36-50, >50), gender and social grade, to explore perceptions of the inserts used in Canada.

RESULTS

The consensus was that these inserts would capture attention and be read due to their novelty and visibility before reaching the cigarettes, and as they can be removed from the pack. While they may be ignored or discarded, and rotation was considered necessary, they were generally thought to prolong the health message. The positive style of messaging was described as refreshing, educational, encouraging, reassuring and inspirational and thought to increase message engagement. It was regarded as more sympathetic than command-style messaging, offering smokers 'a bit of hope'. The inserts were often considered preferable to the on-pack warnings, although it was felt that both were needed. Some participants suggested that inserts could encourage them to stop smoking, and they were generally viewed as having the potential to alter the behaviour of others, particularly younger people, would-be smokers and those wanting to quit.

CONCLUSIONS

Inserts are an inexpensive means of communication and offer regulators a simple way of supplementing on-pack warnings.

Surface modification of platelet concentrate bags to reduce biofilm formation and transfusion sepsis

Bacterial contamination of blood products poses a major risk in transfusion medicine, including transfusions involving platelet products. Although testing systems are in place for routine screening of platelet units, the formation of bacterial biofilms in such units may decrease the likelihood that bacteria will be detected. This work determined the surface properties of p-PVC platelet concentrate bags and investigated how these characteristics influenced biofilm formation. Serratia marcescens and Staphylococcus epidermidis, two species commonly implicated in platelet contamination, were used to study biofilm growth. The platelet concentrate bags were physically flattened to determine if reducing the surface roughness altered biofilm formation. The results demonstrated that the flattening process of the platelet bags affected the chemistry of the surface and reduced the surface hydrophobicity. Flattening of the surfaces resulted in a reduction in biofilm formation for both species after 5 days, with S. marcescens demonstrating a greater reduction. However, there was no significant difference between the smooth and flat surfaces following 7 days' incubation for S. marcescens and no significant differences between any of the surfaces following 7 days' incubation for S. epidermidis. The results suggest that flattening the p-PVC surfaces may limit potential biofilm formation for the current duration of platelet storage time of 5 days. It is hoped that this work will enhance the understanding of how surface properties influence the development of microbial biofilms in platelet concentrate bags in order to devise a solution to discourage biofilm formation.

Proteomic Investigation of Metabolic Changes of Mushroom (Flammulina velutipes) Packaged with Nanocomposite Material during Cold Storage

Metabolic changes of mushroom (Flammulina velutipes) applied with polyethylene (PE) material (Normal-PM) or nanocomposite reinforced PE packaging material (Nano-PM) were monitored using tandem mass tags (TMT) labeling combined with two-dimensional liquid chromatography-tandem mass spectrometry (2D LC-MS/MS) technique. A total of 429 proteins were investigated as differentially expressed proteins (DEPs) among treatments after a cold storage period. A total of 232 DEPs were up-regulated and 65 DEPs were down-regulated in Nano-PM packed F. velutipes compared to that of Normal-PM. The up-regulated DEPs were mainly involved in amino acid synthesis and metabolism, signal transduction, and response to stress while the down-regulated DEPs were largely located in mitochondrion and participated in carbohydrate metabolic, amino acid synthesis and metabolism, and organic acid metabolic. It was also revealed that Nano-PM could inhibit the carbohydrate and energy metabolism bioprocess, promote amino acids biosynthesis, enhance antioxidant system, and improve its resistance to stress, resulting in a further extended shelf life of F. velutipes.

Utilization of chemically treated municipal solid waste (spent coffee bean powder) as reinforcement in cellulose matrix for packaging applications

As the annual production of the solid waste generable in the form of spent coffee bean powder (SCBP) is over 6 million tons, its utilization in the generation of green energy, waste water treatment and as a filler in biocomposites is desirable. The objective of this article is to analyze the possibilities to valorize coffee bean powder as a filler in cellulose matrix. Cellulose matrix was dissolved in the relatively safer aqueous solution mixture (8% LiOH and 15% Urea) precooled to -12.5°C. To the cellulose solution (SCBP) was added in 5-25wt% and the composite films were prepared by regeneration method using ethyl alcohol as a coagulant. Some SCBP was treated with aq. 5% NaOH and the composite films were also prepared using alkali treated SCBP as a filler. The films of composites were uniform with brown in color. The cellulose/SCBP films without and with alkali treated SCBP were characterized by FTIR, XRD, optical and polarized optical microscopy, thermogravimetric analysis (TGA) and tensile tests. The maximum tensile strength of the composite films with alkali treated SCBP varied between (106-149MPa) and increased with SCBP content when compared to the composites with untreated SCBP. The thermal stability of the composite was higher at elevated temperatures when alkali treated SCBP was used. Based on the improved tensile properties and photo resistivity, the cellulose/SCBP composite films with alkali treated SCBP may be considered for packaging and wrapping of flowers and vegetables.

Influencing Eating Choices: Biological Food Cues in Advertising and Packaging Alter Trajectories of Decision Making and Behavior

From an ecological perception perspective (Gibson, 1977), the availability of perceptual information alters what behaviors are more and less likely at different times. This study examines how perceptual information delivered in food advertisements and packaging alters the time course of information processing and decision making. Participants categorized images of food that varied in information delivered in terms of color, glossiness, and texture (e.g., food cues) before and after being exposed to a set of advertisements that also varied in this way. In general, items with more direct cues enhanced appetitive motivational processes, especially if they were also advertised with direct food cues. Individuals also chose to eat products that were packaged with more available direct food cues compared to opaque packaging.

The influence of threatening visual warnings on tobacco packaging: Measuring the impact of threat level, image size, and type of pack through psychophysiological and self-report methods

The first aim of this research was to assess the effectiveness, in terms of emotional and behavioral reactions, of moderately vs. highly TVWs (Threatening Visual Warnings) displayed on tobacco packs. Given the key role that emotional reactions play in explaining the effect of TVWs on behaviors, psychophysiological and self-report methods were used-for the first time in this context-to measure the emotions provoked by TVWs. The second aim of this research was to determine whether increasing the size of warnings, and their display on plain packaging (compared with branded packaging) would improve their effectiveness. A within-subjects experiment was conducted. Three variables were manipulated: health warning threat level (high vs. moderate), image size (40% vs. 75%) and pack type (plain vs. branded). A convenience sample of 48 French daily smokers participated. They were exposed to eight different packs of cigarettes in a research lab at the University of Rennes. Smokers' emotions and behavioral intentions were recorded through self-reports. Emotions were also evaluated using psychophysiological measurements: electrodermal activity and facial electromyography. The results revealed that TVWs with a high threat level are the most effective in increasing negative emotions (fear, disgust, valence, arousal) and behavioral intentions conducive to public health (desire to quit, etc.). They also highlight the appeal of increasing the size of the warnings and displaying them on plain packs, because this influences emotions, which is the first step toward behavioral change. Increasing the threat level of TVWs from moderate to high seems beneficial for public health. Our results also confirm the relevance of recent governmental decisions to adopt plain packaging and larger TVWs (in the UK, France, Ireland, Canada, New Zealand, Hungary, etc.).

Perceptions of branded and plain cigarette packaging among Mexican youth

Plain cigarette packaging, which seeks to remove all brand imagery and standardize the shape and size of cigarette packs, represents a novel policy measure to reduce the appeal of cigarettes. Plain packaging has been studied primarily in high-income countries like Australia and the UK. It is unknown whether the effects of plain packaging may differ in low-and-middle income countries with a shorter history of tobacco regulation, such as Mexico. An experimental study was conducted in Mexico City to examine perceptions of branded and plain cigarette packaging among smoking and non-smoking Mexican adolescents (n = 359). Respondents were randomly assigned to a branded or plain pack condition and rated 12 cigarette packages for appeal, taste, harm to health and smoker-image traits. As a behavioral measure of appeal, respondents were offered (although not given) four cigarette packs (either branded or plain) and asked to select one to keep. The findings indicated that branded packs were perceived to be more appealing (β = 3.40, p < 0.001) and to contain better tasting cigarettes (β = 3.53, p < 0.001), but were not perceived as less harmful than plain packs. Participants rated people who smoke the branded packs as having relatively more positive smoker-image traits overall (β = 2.10, p < 0.001), with particularly strong differences found among non-smokers for the traits 'glamorous', 'stylish', 'popular' and 'sophisticated' (p < 0.001). No statistically significant difference was found for the proportion of youth that accepted when offered branded compared with plain packs. These results suggest that plain packaging may reduce brand appeal among Mexican youth, consistent with findings in high-income countries.

Tobacco packaging design for reducing tobacco use

BACKGROUND

Tobacco use is the largest single preventable cause of death and disease worldwide. Standardised tobacco packaging is an intervention intended to reduce the promotional appeal of packs and can be defined as packaging with a uniform colour (and in some cases shape and size) with no logos or branding, apart from health warnings and other government-mandated information, and the brand name in a prescribed uniform font, colour and size. Australia was the first country to implement standardised tobacco packaging between October and December 2012, France implemented standardised tobacco packaging on 1 January 2017 and several other countries are implementing, or intending to implement, standardised tobacco packaging.

OBJECTIVES

To assess the effect of standardised tobacco packaging on tobacco use uptake, cessation and reduction.

SEARCH METHODS

We searched MEDLINE, Embase, PsycINFO and six other databases from 1980 to January 2016. We checked bibliographies and contacted study authors to identify additional peer-reviewed studies.

SELECTION CRITERIA

Primary outcomes included changes in tobacco use prevalence incorporating tobacco use uptake, cessation, consumption and relapse prevention. Secondary outcomes covered intermediate outcomes that can be measured and are relevant to tobacco use uptake, cessation or reduction. We considered multiple study designs: randomised controlled trials, quasi-experimental and experimental studies, observational cross-sectional and cohort studies. The review focused on all populations and people of any age; to be included, studies had to be published in peer-reviewed journals. We examined studies that assessed the impact of changes in tobacco packaging such as colour, design, size and type of health warnings on the packs in relation to branded packaging. In experiments, the control condition was branded tobacco packaging but could include variations of standardised packaging.

DATA COLLECTION AND ANALYSIS

Screening and data extraction followed standard Cochrane methods. We used different 'Risk of bias' domains for different study types. We have summarised findings narratively.

MAIN RESULTS

Fifty-one studies met our inclusion criteria, involving approximately 800,000 participants. The studies included were diverse, including observational studies, between- and within-participant experimental studies, cohort and cross-sectional studies, and time-series analyses. Few studies assessed behavioural outcomes in youth and non-smokers. Five studies assessed the primary outcomes: one observational study assessed smoking prevalence among 700,000 participants until one year after standardised packaging in Australia; four studies assessed consumption in 9394 participants, including a series of Australian national cross-sectional surveys of 8811 current smokers, in addition to three smaller studies. No studies assessed uptake, cessation, or relapse prevention. Two studies assessed quit attempts. Twenty studies examined other behavioural outcomes and 45 studies examined non-behavioural outcomes (e.g. appeal, perceptions of harm). In line with the challenges inherent in evaluating standardised tobacco packaging, a number of methodological imitations were apparent in the included studies and overall we judged most studies to be at high or unclear risk of bias in at least one domain. The one included study assessing the impact of standardised tobacco packaging on smoking prevalence in Australia found a 3.7% reduction in odds when comparing before to after the packaging change, or a 0.5 percentage point drop in smoking prevalence, when adjusting for confounders. Confidence in this finding is limited, due to the nature of the evidence available, and is therefore rated low by GRADE standards. Findings were mixed amongst the four studies assessing consumption, with some studies finding no difference and some studies finding evidence of a decrease; certainty in this outcome was rated very low by GRADE standards due to the limitations in study design. One national study of Australian adult smoker cohorts (5441 participants) found that quit attempts increased from 20.2% prior to the introduction of standardised packaging to 26.6% one year post-implementation. A second study of calls to quitlines provides indirect support for this finding, with a 78% increase observed in the number of calls after the implementation of standardised packaging. Here again, certainty is low. Studies of other behavioural outcomes found evidence of increased avoidance behaviours when using standardised packs, reduced demand for standardised packs and reduced craving. Evidence from studies measuring eye-tracking showed increased visual attention to health warnings on standardised compared to branded packs. Corroborative evidence for the latter finding came from studies assessing non-behavioural outcomes, which in general found greater warning salience when viewing standardised, than branded packs. There was mixed evidence for quitting cognitions, whereas findings with youth generally pointed towards standardised packs being less likely to motivate smoking initiation than branded packs. We found the most consistent evidence for appeal, with standardised packs rating lower than branded packs. Tobacco in standardised packs was also generally perceived as worse-tasting and lower quality than tobacco in branded packs. Standardised packaging also appeared to reduce misperceptions that some cigarettes are less harmful than others, but only when dark colours were used for the uniform colour of the pack.

AUTHORS' CONCLUSIONS

The available evidence suggests that standardised packaging may reduce smoking prevalence. Only one country had implemented standardised packaging at the time of this review, so evidence comes from one large observational study that provides evidence for this effect. A reduction in smoking behaviour is supported by routinely collected data by the Australian government. Data on the effects of standardised packaging on non-behavioural outcomes (e.g. appeal) are clearer and provide plausible mechanisms of effect consistent with the observed decline in prevalence. As standardised packaging is implemented in different countries, research programmes should be initiated to capture long term effects on tobacco use prevalence, behaviour, and uptake. We did not find any evidence suggesting standardised packaging may increase tobacco use.

Influence of premium versus value brand names on the smoking experience in a plain packaging environment: an experimental study

OBJECTIVE

To examine the effect of branding, as indicated by brand name, on evaluation of the cigarette smoking experience.

DESIGN

Between-subjects and within-subjects experimental study. Participants were randomly allocated to smoke a cigarette from a pack featuring a premium brand name and a cigarette from a pack featuring a value brand name. Within each condition, participants unknowingly smoked two identical cigarettes (either two premium or two value cigarettes).

SETTING

Australia, October 2014, 2 years after tobacco plain packaging implementation.

PARTICIPANTS

81 current cigarette smokers aged 19-39 years. From apparently premium and value brand-name packs, 40 smokers were allocated to smoke the same actual premium cigarettes and 41 were allocated to smoke the same actual value cigarettes.

PRIMARY OUTCOME MEASURES

Experienced taste (flavour, satisfaction, enjoyment, quality, liking, mouthfeel and aftertaste), harshness, dryness, staleness, harm/strength measures (strength, tar, lightness, volume of smoke), draw effort and purchase intent.

RESULTS

Cigarettes given a premium brand name were rated as having a better taste, were less harsh and less dry than identical cigarettes given a value brand name. This pattern was observed irrespective of whether the two packs actually contained premium or value cigarettes. These effects were specific: the brand name did not influence ratings of cigarette variant attributes (strength, tar, volume of smoke, lightness and draw effort).

CONCLUSIONS

Despite the belief that brand names represent genuine differences between cigarette products, the results suggest that at least some of this perceived sensory difference is attributable to brand image.

Effect of Packaging on Shelf-life and Lutein Content of Marigold (Tagetes erecta L.) Flowers

BACKGROUND

African marigold (Tagetes erecta L.) flowers are highly valued for their ornamental appeal as well as medicinal properties. However, their short shelf lives cause high post-harvest loss and limit their export potential. The review of patents and research articles revealed that different types of packaging designs/materials have been successfully employed for extension of shelf lives of cut flowers.

OBJECTIVE

The current work focuses on designing of different packaging configurations and selection of best configuration for preservation of marigold cut flowers.

METHODS

Ten packaging configurations, composed of four different packaging materials i.e., low density polyethylene (LDPE), polyethylene terephthalate, glassine paper and cellophane paper, were designed. Each pack, consisting of 20 ± 1 g of marigold flowers along with non-packaged control set were stored at 23 ± 2°C, 80% R.H., in an environmental chamber and the flowers were evaluated for their sensory attributes, phytochemical characteristics and physicochemical parameters of senescence to determine their shelf lives.

RESULTS

Flowers packed in LDPE bag showed highest shelf life of 8 days with a lead of 4 days compared to control (shelf life - 4 days). This study also established for the first time the phenomenon of carotenogenesis in marigold cut flowers with significantly (P<0.01) higher production of lutein in LDPE packaged flowers.

CONCLUSION

LDPE pack was the best design among the ten package designs, in preserving lutein content of marigold flowers and extending their shelf lives. This economically viable packaging can not only boost the export potential of this ornamental flower, but also allow utilization of nutraceutical potency of lutein.

Sterility maintenance study: Dynamic evaluation of sterilized rigid containers and wrapped instrument trays to prevent bacterial ingress

BACKGROUND

Sterilized packaging systems are designed to maintain the sterility of surgical instruments and devices from the time of sterilization until use. This study evaluated the effectiveness of rigid containers versus wrapped instrument trays, sterilized using North American sterilization protocols, to maintain a sterile internal environment poststerilization when challenged with aerosolized bacteria under dynamic environmental conditions.

METHODS

Using a custom aerosol chamber, 111 rigid containers of various durations of use (unused, used <5 years, used 5-9 years) and 161 wrapped trays using 3 grades of sterilization wrap were challenged with ~10(2) colony-forming units per liter of air containing aerosolized Micrococcus luteus with a count median particle size of 1 μm, while simultaneously experiencing air volume exchanges due to vacuum cycles-two 1-psi cycles, three 0.7-psi cycles, and three 0.4-psi cycles-to simulate air exchange events occurring during the sterilization, transportation, and storage of sterilized instrument trays in health care facilities.

RESULTS

Of 111 rigid containers tested, 97 (87%) demonstrated bacterial ingress into the container. Of 161 wrapped trays, 0 (0%) demonstrated bacterial ingress into the tray. Contamination rates of rigid containers increased significantly with increasing duration of use.

CONCLUSIONS

In this study using a dynamic bacterial aerosol challenge, sterilized wrapped trays demonstrated significantly greater protection than sterilized rigid containers against the ingress of airborne bacteria.

The Use of Cigarette Package Inserts to Supplement Pictorial Health Warnings: An Evaluation of the Canadian Policy

BACKGROUND

Canada is the first country in the world to require cigarette manufacturers to enclose package inserts to supplement the exterior pictorial health warning label (HWL). In June 2012, Canada implemented new HWL package inserts that include cessation tips accompanied by a pictorial image. This study aims to assess the extent to which adult smokers report reading the newly mandated HWL inserts and to see whether reading them is associated with making a quit attempt.

METHODS

Data were analyzed from an online consumer panel of Canadian adult smokers, aged 18-64 years. Five waves of data were collected between September 2012 and January 2014, separated by 4-months intervals (n = 1,000 at each wave). Logistic generalized estimating equation (GEE) models were estimated to assess correlates of reading inserts and whether doing so is associated with making a quit attempt by the subsequent wave.

RESULTS

At each wave, between 26% and 31% of the sample reported having read HWL package inserts at least once in the prior month. Smokers who read them were more likely to be younger, female, have higher income, intend to quit, have recently tried to quit, and thought more frequently about health risks because of warning labels. In models that adjusted for these and other potential confounders, smokers who read the inserts a few times or more in the past month were more likely to make a quit attempt at the subsequent wave compared to smokers who did not read the inserts.

CONCLUSIONS

HWL package inserts with cessation-related tips and messages appear to increase quit attempts made by smokers.