title: Cigarette pack design and perceptions of risk among UK adults and youth.
abstract: BACKGROUND
  It is illegal in the EU for tobacco packaging to suggest that some cigarettes are safer than others. This study examined consumer perceptions of cigarette packs in the UK, including perceptions of 'plain packaging', in which colour and other design elements are removed, whilst retaining the brand name.
  
  
  METHODS
  516 adult smokers and 806 youth aged 11-17 participated in an online survey. Participants were asked to compare pairs of cigarette packs on five measures: taste, tar delivery, health risk, attractiveness and either ease of quitting (adult smokers) or brand they would choose if trying smoking (youth).
  
  
  RESULTS
  Adults and youth were significantly more likely to rate packs with the terms 'smooth', 'silver' and 'gold' as lower tar, lower health risk and either easier to quit smoking (adults) or their choice of pack if trying smoking (youth). For example, more than half of adults and youth reported that brands labelled as 'smooth' were less harmful compared with the 'regular' variety. The colour of packs was also associated with perceptions of risk and brand appeal: compared with Marlboro packs with a red logo, Marlboro packs with a gold logo were rated as lower health risk by 53% and easier to quit by 31% of adult smokers. Plain packs significantly reduced false beliefs about health risk and ease of quitting, and were rated as significantly less attractive and appealing to youth for trying smoking.
  
  
  CONCLUSIONS
  Current regulations have failed to remove potentially misleading information from tobacco packaging. Removing colours from packs (plain packaging), as well as terms such as 'smooth' 'gold' and 'silver' would significantly reduce false beliefs and increase compliance with existing legislation.
authors.affiliation: Department of Health Studies & Gerontology, University of Waterloo, Waterloo, Ontario, Canada. dhammond@uwaterloo.ca
authors.forename: David
authors.initials: D
authors.lastname: Hammond
authors.forename: Martin
authors.initials: M
authors.lastname: Dockrell
authors.forename: Deborah
authors.initials: D
authors.lastname: Arnott
authors.forename: Alex
authors.initials: A
authors.lastname: Lee
authors.forename: Ann
authors.initials: A
authors.lastname: McNeill
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002648:Child; D003625:Data Collection; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D040541:Marketing; D019064:Product Packaging / Q000331:legislation & jurisprudence; D012306:Risk; D012907:Smoking / Q000523:psychology*; D006113:United Kingdom