Association between tobacco plain packaging and Quitline calls: a population-based, interrupted time-series analysis.
OBJECTIVE
To investigate whether the introduction of tobacco plain packaging in Australia from 1 October 2012 was associated with a change in the number of calls to the smoking cessation helpline, Quitline, and to compare this with the impact of the introduction of graphic health warnings from 1 March 2006.


METHODS
Whole-of-population interrupted time-series analysis in New South Wales and the Australian Capital Territory between 1 March 2005 and October 2006 for the comparator, graphic health warnings, and October 2011 and April 2013 for the intervention of interest, tobacco plain packaging.


METHODS
Weekly number of calls to the Quitline, after adjusting for seasonal trends, anti-tobacco advertising, cigarette costliness and the number of smokers in the community.


RESULTS
There was a 78% increase in the number of calls to the Quitline associated with the introduction of plain packaging (baseline, 363/week; peak, 651/week [95% CI, 523-780/week; P < 0.001]). This peak occurred 4 weeks after the initial appearance of plain packaging and has been prolonged. The 2006 introduction of graphic health warnings had the same relative increase in calls (84%; baseline, 910/week; peak, 1673/week [95% CI, 1383-1963/week; P < 0.001]) but the impact of plain packaging has continued for longer.


CONCLUSIONS
There has been a sustained increase in calls to the Quitline after the introduction of tobacco plain packaging. This increase is not attributable to anti-tobacco advertising activity, cigarette price increases nor other identifiable causes. This is an important incremental step in comprehensive tobacco control.
Cancer Epidemiology and Services Research (CESR), Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia. jane.young@sydney.edu.au.
Jane M
JM
Young
Cancer Institute NSW, Sydney, NSW, Australia.
Ingrid
I
Stacey
Cancer Epidemiology and Services Research (CESR), Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.
Timothy A
TA
Dobbins
Cancer Institute NSW, Sydney, NSW, Australia.
Sally
S
Dunlop
Cancer Institute NSW, Sydney, NSW, Australia.
Anita L
AL
Dessaix
Cancer Institute NSW, Sydney, NSW, Australia.
David C
DC
Currow
D001315:Australia / Q000453:epidemiology; D015277:Hotlines / Q000706:statistics & numerical data*; D006801:Humans; D019064:Product Packaging / Q000331:legislation & jurisprudence / Q000379:methods / Q000706:statistics & numerical data; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D062789:Tobacco Products / Q000009:adverse effects / Q000706:statistics & numerical data