L2 all au plain packaging

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L2 all au plain packaging

  1. 1. Design of plain packaged cigarette packswith updated and expanded graphic health warnings
  2. 2. Example of plain packaged cigarette packs with updated and expanded graphic health warnings Front of pack: Back of pack:
  3. 3. Example of plain packaged cigarette packs with updated and expanded graphic health warnings Front of pack: Back of pack:
  4. 4. Example of plain packaged cigarette packs with updated and expanded graphic health warnings Front of pack: Back of pack:
  5. 5. Research to determine thelook of Australian plainpacksMelanie Wakefield PhD, Cancer Council Victoria, Australia
  6. 6. Research approachDepartment of Health & Ageing: Simon Cotterell, KylieLindorff and other key staffExpert Advisory GroupProf Ron Borland Mr Jonathan LibermanProf Mike Daube Dr Caroline MillerProf Mark Davidson Prof Andrew MitchellA/Prof David Hammond Prof Melanie WakefieldProf Janet HoekGFK Blue Moon (fieldwork agency contracted by DoHA)
  7. 7. Overview of studies A series of iterative studies were conducted to determine: • Optimal colour for plain packaging; • Optimal font and font size for brand name; • Graphic health warning (GHW) size and layout Identify one plain packaging design (colour, font) that would minimise appeal and attractiveness, while maximising perceived harm and noticeability of health warningshttp://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/mr-plainpack Selection of new health warnings subject to their own testing process
  8. 8. Study 2: pack colour shortlist Study Objectives Methodology TimingStudy 2 To identify a • Online study among (n=409) at least 13 - 23 shortlist of weekly smokers, aged 18-65 years Dec 2010 potential • Rating task used Best-Worst plain methodology with 8 pack colours packaging • Smokers shown 4 pack images at a colours time, select best and worst on each dimension, then repeat with different subset until all packs rated
  9. 9. Study 2Shortlist of potential plain package colours • 8 colours tested • Darker colours perceived to be more harmful and more difficult to quit • Dark brown colour: perceived to be least appealing; the lowest quality cigarette; most harmful to health; hardest to quit
  10. 10. Study 3: readability test Study Objectives Methodology Timing Study 3 To identify the • Face-to-face 17-21 optimal interviews of 10 Dec combination of respondents aged ≥40 2010 design elements years (font size, font • The test used colour) for legibility ‘eyeboards’ - boards and ease of with brand names in identification decreasing font size amongst potential • Also used mock up retailers packs with brand names in different font sizes
  11. 11. Study 3Readability of fonts for potential retailers • Test used Dark Brown and Mustard colours from Study 2 • Tested smallest font able to be read at 1 metre distance • Size 14 Arial or Lucida Sans font style • BUT some favourable comments about Dark Brown colour (“chocolate”) and unfavourable about Mustard (“sickly”) when viewed in the flesh
  12. 12. Study 4: online “Face-off”Study Objectives Methodology TimingStudy 4 To shortlist • ‘Face-off’ between Dark 19 Dec plain Brown and Mustard 2010 –26 packaging • Online survey among 455 Jan 2011 colours that at least weekly smokers minimise aged 18-64 years brand impact • Best-Worst methodology, with 5 common Australian brand names covering the three main market segments • Used two existing health warnings
  13. 13. Study 4Consumer perceptions of Dark Brown vs Mustard • Dark Brown - most reported seeing “Dark Olive” colour on screen • Mustard - half reported seeing „gold‟…viewed as „striking‟, „prestigious‟, similar to premium brands B&H, Dunhill • Dark Brown colour - rated as less appealing, most harm, lower quality, want to smoke them less, with similar results across all 5 brands tested • Noticeability of GHWs: darker colour did not detract from noticeability of GHW
  14. 14. Study 5a: face-to-face, new HW sizeStudy Objectives Methodology TimingStudy 5 To identify the • 20 face-to-face group clinics 14 – (face- optimal plain involving a self-completion 22 Feb to- packaging designs questionnaire and short group 2011 face) in combination with discussion among 193 at least the new front of weekly smokers aged 16-64 pack graphic health years warnings: • Tested 3 different shades of brown-olive background colour Identify exact shade and 3 different HW sizes of plain pack colour • Used mocked-up pack protoypes Identify optimal new • Best-Worst comparisons, pack GHW size ratings and qualitative comments
  15. 15. Study 5a: Face-to-Face, new HW sizeMocked up versions of Dark Brown, Dark Olive (matchingonline perception), and Medium Olive with 30%, 60% or75% GHW • All three colours perceived as unappealing; Dark Olive more so • Dark Olive had no positive associations: “death”, “dirty”, “tar” • Dark Brown some positive associations: “classy”, “rich”, “chocolate”, “upmarket” • 75% GHW had significantly stronger impact than 30%
  16. 16. Study 5b: online, new HWs placement Study Objectives Methodology TimingStudy 5 To identify the optimal • Online survey among 18 – 23(online) plain packaging designs 409 at least weekly Feb 2011 in combination with the smokers aged 18-64 new front of pack • Used pack images in GHWs Dark Olive colour for each of 2 HWs – ‘lung Identify GHW size and cancer‘ and ‘smoking placement to maximise harms unborn babies’ noticeability and impact • Individual pack ratings and Best-Worst ratings
  17. 17. Study 5b: OnlineIdentify GHW size and layout to maximise noticeability andimpact • 4 packs using the Dark Olive colour for 2 HWs • 30%, 60%, 75% and split 60% • 75% had highest noticeability and strongest “stop and think” impact • Split 60% warning no better than 30%
  18. 18. Study 6 Study Objectives Methodology Timing Study 6 To identify the Online survey among 18 – 23 (online) optimal (n=205) at least March plain packaging weekly smokers aged 2011 designs 18-64 years in combination with the As for Study 5 online new front of pack GHWs: Rate the 75% split design against other options
  19. 19. Study 6: OnlineCompare 75% to split 75% GHW • Non-split 75% GHW was more noticeable and had highest impact
  20. 20. Australian plain packs• Dark Olive colour• Brand name 14 point Lucida Sans font• 75% non-split GHWFull report (and report on testing of other tobacco products) at:http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/mr-plainpack
  21. 21. PLAIN PACKAGING IN AUSTRALIA – KEY FACTORS Slide acknowledgements: R. Moodie, S. Chapman, M. Scollo, B. Freeman, M. Swanson, D. Sullivan, F. Sharkie, O. Freedman, L. Sylvan and the people who make slides for Todd Harper.
  22. 22. • Historical context• National Preventative Health Taskforce• The political context• Two episodes• What made the difference
  23. 23. OVERNIGHT SUCCESS COMES SLOWLYEVIDENCE1950 - Doll and Hill (BMJ), Wynder and Graham(JAMA)1962 – Royal College of Physicians1964 – US Surgeon GeneralACTION RECOMMENDATIONS1976 – UICC – Guidelines for Smoking Control1977 – RCP – 3rd report1979 – WHO – Controlling the Smoking Epidemic
  24. 24. TOBACCO CONTROL AUSTRALIA in 2008 – Over- simplified summary (Note - mix of Federal and State activity)Tobacco advertising bans since late 80s/early 90sHealth warnings since 1973, increasing strength every decade – 1973,1987, 1995, 2006Continuing State legislation/action (leapfrog effect)Bans on point-of-sale promotionStrong measures to protect non-smokers – cars around kids, bars andrestaurants, other public places (including some beaches)National and State media campaignsStrong, cohesive advocacy organisations, individuals, coalitions –Cancer, Heart, AMA, AMA, ASH, ACOSH, PHAA – and many othersContinuing new approaches to media and media coverageCessation support – NRT, Quitlines, etc(Industry last 10 – 15 years – much lobbying and working throughothers but staying below parapet )
  25. 25. WHERE NEXT?
  26. 26. New Government 2008 – policies on prevention“(The Government)….. “will treat preventative health care as a first order economic challenge because failure to do so results in a long term negative impact on workforce participation, productivity growth and the impact on the overall health budget”. Prime Minister Kevin Rudd, June 2008 Appointed Health Minister – Hon Nicola Roxon MP
  27. 27. New Government 2008• Commitment to Prevention• Three major health reviews: Healthy system and hospitals; Primary Care; National Preventative Health Taskforce
  28. 28. Chair: Members:Professor Rob Moodie Professor Paul Zimmet Professor Leonie Segal Dr Lyn RobertsDeputy Chair: Mr Shaun LarkinProfessor Mike Daube Ms Kate Carnell Dr Christine Connors Dr Linda Selvey  Task: Develop the National Preventative Health Strategy by June 2009.  Focus on obesity, tobacco and excessive consumption of alcohol
  29. 29. To support the development of the Strategy, the Taskforceestablished working groups for each of:• obesity (Chair – Dr. Lyn Roberts)• tobacco (Chair – Professor Mike Daube)• alcohol (Chair – Professor Rob Moodie)Tobacco Committee: V. Briggs, S. Chapman, M. Daube, S.Larkin, K. Purcell, L. Roberts, M. Scollo (writer), D. Sullivan,M. Wakefield.
  30. 30. Overwhelming support from health groupsand community
  31. 31. PASSING THE SCREAM TEST* BATA submission to Taskforce“BAT believes there is already a significant amount of regulation on tobaccoproducts and there may now be a risk of too much, with unintendedconsequences of progressing further.”* Plain packaging/pack display – part of multi-focused Discussion Paper* Industry responses (BAT, Imperial, Philip Morris) – 43 out of 142 pages
  32. 32. Report presented to Minister 30 June 2009 15
  33. 33. • 2020 Targets Halt and reverse rise in overweight and obesityReduce daily smoking from 16.6% to 10.0% or less Reduce the proportion who drink at short term harm from 20% to 14% and the proportion drinking at longer term harm from 10% to 7% Contribute to the ‘Close the Gap’ target for Indigenous people
  34. 34. Tobacco – Comprehensive approach 11 componentsPACKAGINGACTION PROPOSEDREQUIRE ALL TOBACCO PRODUCTSTO BE SOLD IN PLAIN PACKAGING, THEEXACT APPEARANCE OF WHICH(PRECISE COLOUR, PAPER FINISH,SHAPE OF PACK ETC) COULD BEPRESCRIBED IN REGULATIONS UNDERTHE TRADE PRACTICES ACT 1974.COMMISSION RESEARCH TODETERMINE EXACTLY HOW PACKSSHOULD BE DESIGNED TO MINIMISEAPPEAL TO YOUNG PEOPLE
  35. 35. Continuing research• Australia (Wakefield et al)• Canada (Hammond et al)• New Zealand (Hoek et al)• US (FDA et al)• UK (Various….)
  36. 36. Review in Addiction, 2008 21
  37. 37. WHO Framework Convention on Tobacco Control 22
  38. 38. Why Plain Packaging?• Not a magic bullet• Not in isolation – part of comprehensive approach• Supports rest of program• Research evidence• Industry documents evidence• Campaign, response and coverage• Industry opposition – passes the Scream Test• International implications
  39. 39. GOVERNMENT• Release September 1st 2009• Minister Roxon – “We are killing people by not acting”
  40. 40. Action On Tobacco After ReportCurrent/further developing national and state programs – dealing with• loopholes in ad ban legislation;• bans on any display at point of sale;• further protection for non-smokers;• media campaigns;• specific education and support for disadvantaged groups; etc.
  41. 41. Action After Report on Tobacco - 2Federal GovernmentProgressive Implementation of Taskforcerecommendations – includes:• 25% increase tobacco excise duty• Established Australian National Preventive Health Agency• Major, continuing funding for tobacco media• Tackling Indigenous Smoking Initiative (over $100m over four years)• Cessation supports – NRT, Quitlines, etc.• Ban internet advertising
  42. 42. APRIL 29, 2010
  43. 43. THE POLITICS• Minority Government – needed support of 2 of 3 Independents in Lower House• Majority in Senate, with strong support from Greens• Opposition oppositional….Opposing everything• Opposition Federally still taking tobacco donations (not Government or Greens)• Industry lobbying heavily• Tortuous Parliamentary processes• Major, coordinated health lobbying campaign• Aims – maintain support; secure and maintain independents’ support; seek at least some Opposition members’ support; ideal all- party support.
  44. 44. The Political SceneCountering the industry lobby – SimonChapman paper
  45. 45. REPUTATION INSTITUTE - Global Industry Results Consumer Products 73.8Electrical & Electronics 73.2 Computer 70.3 Retail - General 70.3 Industrial Products 70.2 Retail - Food 69.9 Food - Manufacturing 69.4 Beverage 68.0 Automotive 67.9 Pharmaceuticals 65.9 Airlines & Aerospace 65.8 Services 65.0 Information & Media 64.4 Conglomerate 64.1 Chemicals 63.7 Raw Materials 63.7 Construction &… 62.6 Transport & Logistics 62.6 Financial - Diversified 61.9 Financial - Insurance 61.6 Energy 60.8 Financial - Bank 60.5 Telecommunications 59.8 Utilities 59.0 Excellent/Top Tier above 80 Strong/Robust 70-79 Tobacco 50.1 Average/Moderate 60-69 Weak/Vulnerable 40-59 Poor/Lowest Tier below 40
  46. 46. Public support very high• April 2011: A survey of 4,500 Victorians showed very strong support.• 72% of all people approve of the policy - and 57% of smokers. 32
  47. 47. Health Coalition• Government strong and active• Minister leading from front• Health Department strong backing• Major health groups and experts working nationally as cohesive coalition• Cancer Councils, Heart Foundation, Australian Medical Association, QUIT campaigns, ASH, ACOSH, Public Health Association, and other health organisations• Prominent experts (Simon who?), health/medical leaders• Media, media, media - Proactive, reactive• Responding to industry campaigns, exposing industry tactics, research, reports, surveys, advertisements…• Active support from politicians of all parties• Lobbying, lobbying, lobbying – all parties, all members
  48. 48. Two Episodes
  49. 49. Midnight Emails
  50. 50. Opposition Leader Tony Abbott has said he would support any move to curb smokingrates, but he has refused to back the governments proposal. My anxiety with this[plain packaging proposal] is that it may end up being counterproductive in practice,he said.But Liberal MP Mal Washer broke ranks with his leader when contacted by TheSunday Age last week. Dr Washer, who spent 26 years as a medical practitionerbefore moving into federal politics, gave a blunt assessment of the tobacco industrysstrategy.All this talk of chop chop and crime gangs sounds like bullshit to me. The tobaccoindustry is jumping up and down because theyre worried about their businesses. Isupport these reforms unequivocally and whatever my party decides to do, I dont givea shit, Dr Washer said.He said smoking killed about 19,000 Australians each year, and governments had amoral responsibility to implement any measure that could stop young people fromtaking up the habitThe Age, May 22, 2011
  51. 51. WHAT MADE THE DIFFERENCE? - 1• Government that understood prevention• Recognition of population approach• Superb Minister – willing to take on industry• Department with strong support: can-do public servants• Context – history; comprehensive approach; PP as next stage
  52. 52. WHAT MADE THE DIFFERENCE? - 2• Good process• Coalition – key health organisations and individuals - experienced, collegial, creative, planned, opportunistic• Sound science and scientists• Strong bureaucratic backing
  53. 53. WHAT MADE THE DIFFERENCE? - 3• Media• Public opinion• International support• Principled politicians
  54. 54. WHAT MADE THE DIFFERENCE? - 4• Industry – credibility already gone - desperation evident (heads above parapet; dishonest tactics) - feeble/contradictory arguments - internationally controlled - evidently worried by global implications - weak in media - bullying governments - the louder they shout…..
  55. 55. Tobacco industry reaction to plainpackaging 2010-2011, AustraliaWhat other nations can expect Prof Simon Chapman School of Public Health University of Sydney Twitter: simonchapman6
  56. 56. Highly recommended 2
  57. 57. Main arguments (1) general never been done before … so don’t do it! “no evidence” it will work makes packs easier to counterfeit … illicit trade already massive: will get worse will force fierce price competition, lowering prices … more smokers, especially youth will confuse customers, staff, increase serving times “nanny state” running amok slippery slope: other products next? we can’t possibly comply in time: delay needed
  58. 58. Main arguments (2) legal Violates Australian constitution + WTO’s TRIPS (trade-related aspects of intellectual property rights) agreement Trade mark, intellectual property confiscation therefore large damages will be due 4
  59. 59. Argument 1: Never been done before .. therefore “no evidence”Should wenever doanything forthe first time? 5
  60. 60. Other firsts in public health Other firsts  Seat belts • “Great argument: its never been done before, therefore you  RBT shouldnt do it. This is the poor little stupid Australia  Advertising bans argument. We should always merely follow the lead of other  Vaccination countries because were not smart enough to dream up  Lead free petrol anything good ourselves.. But if the ideas so unlikely to. .  Parachutes! (never any RCTs!) work, why are the global giants fighting so hard to stop  ...100s more examples it? “ – journalist Ross Gittins
  61. 61. The Principle of the Dangerous Precedent  “Every public action which is not customary either is wrong, or if it is right it is a dangerous precedent. It follows that nothing should ever be done for the first time.” Microcosmographia Academica (1908)
  62. 62. Our 3 most powerful arguments1. Packaging = centrepiece of promotions: we are finishing the job of banning all advertising2. It will have its greatest impact with the next generation by reducing uptake, not current smokers3. If it “won’t work”, then why is the global tobacco industry having weapons’ grade apoplexy? 8
  63. 63. Argument 2: ““no evidence” (of any sort) that it will workBAT advertisement 31 page dossier 9
  64. 64. Best evidence found in industry sources 10
  65. 65. Argument 3: it will make packs easier to counterfeit …Current packs areVERY easy to copyalready! 11
  66. 66. 12
  67. 67. Argt 4: Illicit trade will boom16% (>1 in 6) of all tobaccoconsumed = illicit. 13
  68. 68. Argument 4: Illicit trade will boom, prices will fall, more kids will smokeIf prices fall, government can put up tax within 24hrs 14
  69. 69. Argument 5: All packs “look the same” Shopkeeper & customer confusionhttp://www.plain-packaging.com 15
  70. 70. …but it may well decrease transaction times  16
  71. 71. Argument 6: Nanny state 17
  72. 72. Argument 7: Slippery slope … what’s next?  Advertising bans began in 1976 – 36 years ago!  The slope is not very slippery  No other product remotely kills half its users
  73. 73. Argument 8: We need 17 months AFTER legislation to comply 19
  74. 74. Legal arguments: does it violate the Australian constitution?
  75. 75. TRIPS/World Trade Organisation The right given to a trademark owner under TRIPS is to prevent other people from using that trade mark. The plain packaging legislation does not permit other people to use the trade marks of the tobacco industry, so it does not contravene that right.
  76. 76. TRIPS/World Trade Organisation• Article 20 provides that “the use of a trade mark in the course of trade shall not be unjustifiably encumbered by special requirements”.• So is their use is “unjustifiably encumbered”?• Article 8 TRIPS provides that countries may take measures “necessary for public health” provided they are consistent with the rest of the agreement.
  77. 77. Why does not… the liquor industry sue Islamic nations for prohibition? the asbestos industry sue governments for banning its use? Firearms manufacturers sue governments for gun control laws? the pharmaceutical industry sue governments for the gross restrictions on sale & advertising of prescribed pharmaceuticals? Exotic animals industry sue governments for quarantine laws?
  78. 78. Timeline: Philip Morris Hong Kong-Australian bilateral treatyDate Event29 April 2010 • Australian Government announces its decision to implement plain packaging.remainder of 2010 • Objections and complaints made by Philip Morris entities toand early 2011 the effect that plain packaging would breach Australia’s international trade and treaty obligations.23 February 2011 • PMA purchases Philip Morris Australia.27 June 2011 • PMA services Notice of Claim to the Australian Government.21 November 2011 • Tobacco Plain Packaging Bill 2011 (Cth) passes Australian Parliament. • PMA submits Notice of Arbitration to the Australian Government.1 December 2011 • Legislation receives Royal Assent: Tobacco Plain Packaging Act 2011 (Cth)21 December 2011 • Australian Government submits its response to the Notice of Arbitration.
  79. 79. The hunt for the $3billion/year factoidBritishAmericanTobacco 25
  80. 80. Between 1999 and 2003 the average annual fallin total dutied cigarettes was just 2.6%.The most sales have ever fallen in one year wasjust shy of 10% in 1999
  81. 81. Other industry tactics Established 3rd Party “independent” spokesgroups Right-wing shock-jocks enlisted Freedom of Information used for “fishing trips” BAT used Twitter & held a rare press conference 27
  82. 82. Comparison with packaging of prescribed pharmaceuticals 28
  83. 83. (then) Health Minister , Nicola Roxon,at UN Summit on NCDs, 2011 29

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