The impact of cigarette package design on young women in Brazil: brand appeal and perceptions of health risk
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Tobacco use is responsible for 5.4 million deaths every year worldwide and a leading cause of preventable death. The burden of these deaths is rapidly shifting to low and middle-income countries, such as Brazil. Brazil is widely regarded as an international leader in tobacco control. The country has prohibited most forms of advertising; however, the cigarette pack remains a primary source of tobacco marketing. The current study sought to examine how tobacco packaging influences brand appeal and perceptions of health risk among female youth in Brazil. A between-subjects experiment was conducted in which 640 Brazilian females between the ages of 16 to 26 years participated in an online survey. Each participant was asked to view and rate a series of cigarette packages that were digitally altered to correspond to one of three experimental conditions: (1) “standard” branded cigarette packages, (2) the same packs with all brand imagery removed (“plain packaging”), or (3) the same packs with all imagery and brand descriptors removed. Participants rated the packages on perceived appeal, taste, smoothness, health risk, ease of quitting, desirability to be seen smoking, preference to try, and smoker attributes through single pack ratings and two-pack comparisons. A pack offer was used as a behavioural measure of general appeal. Linear and logistic regression modeling was used to test for differences between and within experimental conditions. Branded packs were rated as significantly more appealing, better tasting, and smoother on the throat than plain packs. Branded packs were also associated with a greater number of positive smoker attributes including style and sophistication, and were perceived as more likely to be smoked by females than the plain packs. Removing descriptors from the plain packs further decreased the ratings of appeal, taste and smoothness, and also reduced associations with positive attributes. Results of the study also indicated that packages marketed as lighter, through use of lighter coloured pack imagery, and descriptors referring to lighter colours and flavours, were more likely to be rated favourably. Over 52% of participants accepted a pack offer at the end of the study, and of those who selected a pack, more than three-quarters chose a branded pack over a plain pack. Overall, the findings suggest that plain packaging and removing descriptors from cigarette packs, including those that refer to flavours, may help to reduce the appeal of smoking, and consequently reduce smoking susceptibility among young women in Brazil.