The document summarizes research conducted in Australia to determine the optimal design of plain cigarette packaging, including selecting a drab color, font style and size for the brand name, and expanding the size and placement of graphic health warnings. Through a series of online and in-person studies, researchers identified "Dark Olive" as the best color and a 75% non-split graphic health warning as providing the greatest impact.

1. Design of plain packaged cigarette packs
with updated and expanded graphic health warnings

2. Example of plain packaged cigarette packs
with updated and expanded graphic health warnings
Front of pack: Back of pack:

3. Example of plain packaged cigarette packs
with updated and expanded graphic health warnings
Front of pack: Back of pack:

4. Example of plain packaged cigarette packs
with updated and expanded graphic health warnings
Front of pack: Back of pack:

5. Research to determine the
look of Australian plain
packs
Melanie Wakefield PhD, Cancer Council Victoria, Australia

6. Research approach
Department of Health & Ageing: Simon Cotterell, Kylie
Lindorff and other key staff
Expert Advisory Group
Prof Ron Borland Mr Jonathan Liberman
Prof Mike Daube Dr Caroline Miller
Prof Mark Davidson Prof Andrew Mitchell
A/Prof David Hammond Prof Melanie Wakefield
Prof Janet Hoek
GFK Blue Moon (fieldwork agency contracted by DoHA)

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
warnings
http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/mr-plainpack
Selection of new health warnings subject to their own
testing process

8. Study 2: pack colour shortlist
Study Objectives Methodology Timing
Study 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. Study 2
Shortlist 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. 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. Study 3
Readability 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. Study 4: online “Face-off”
Study Objectives Methodology Timing
Study 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. Study 4
Consumer 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. Study 5a: face-to-face, new HW size
Study Objectives Methodology Timing
Study 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. Study 5a: Face-to-Face, new HW size
Mocked up versions of Dark Brown, Dark Olive (matching
online perception), and Medium Olive with 30%, 60% or
75% 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. Study 5b: online, new HWs placement
Study Objectives Methodology Timing
Study 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. Study 5b: Online
Identify GHW size and layout to maximise noticeability and
impact
• 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. 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. Study 6: Online
Compare 75% to split 75% GHW
• Non-split 75% GHW was more noticeable and had highest impact

20. Australian plain packs
• Dark Olive colour
• Brand name 14 point Lucida Sans font
• 75% non-split GHW
Full report (and report on testing of other tobacco products) at:
http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/
mr-plainpack

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. • Historical context
• National Preventative Health Taskforce
• The political context
• Two episodes
• What made the difference

23. OVERNIGHT SUCCESS COMES SLOWLY
EVIDENCE
1950 - Doll and Hill (BMJ), Wynder and Graham
(JAMA)
1962 – Royal College of Physicians
1964 – US Surgeon General
ACTION RECOMMENDATIONS
1976 – UICC – Guidelines for Smoking Control
1977 – RCP – 3rd report
1979 – WHO – Controlling the Smoking Epidemic

25. TOBACCO CONTROL AUSTRALIA in 2008 – Over-
simplified summary (Note - mix of Federal and State
activity)
Tobacco advertising bans since late 80s/early 90s
Health warnings since 1973, increasing strength every decade – 1973,
1987, 1995, 2006
Continuing State legislation/action (leapfrog effect)
Bans on point-of-sale promotion
Strong measures to protect non-smokers – cars around kids, bars and
restaurants, other public places (including some beaches)
National and State media campaigns
Strong, cohesive advocacy organisations, individuals, coalitions –
Cancer, Heart, AMA, AMA, ASH, ACOSH, PHAA – and many others
Continuing new approaches to media and media coverage
Cessation support – NRT, Quitlines, etc
(Industry last 10 – 15 years – much lobbying and working through
others but staying below parapet )

26. WHERE NEXT?

27. 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

28. New Government 2008
• Commitment to Prevention
• Three major health reviews: Healthy
system and hospitals; Primary Care;
National Preventative Health Taskforce

29. Chair: Members:
Professor Rob Moodie Professor Paul Zimmet
Professor Leonie Segal
Dr Lyn Roberts
Deputy Chair:
Mr Shaun Larkin
Professor 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

30. To support the development of the Strategy, the Taskforce
established 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.

32. Overwhelming support from health groups
and community

34. PASSING THE SCREAM TEST
* BATA submission to Taskforce
“BAT believes there is already a significant amount of regulation on tobacco
products and there may now be a risk of too much, with unintended
consequences of progressing further.”
* Plain packaging/pack display – part of multi-focused Discussion
Paper
* Industry responses (BAT, Imperial, Philip Morris) – 43 out of 142
pages

35. Report presented to Minister 30
June 2009
15

36. • 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

37. Tobacco – Comprehensive approach
11 components
PACKAGING
ACTION PROPOSED
REQUIRE ALL TOBACCO PRODUCTS
TO BE SOLD IN PLAIN PACKAGING, THE
EXACT APPEARANCE OF WHICH
(PRECISE COLOUR, PAPER FINISH,
SHAPE OF PACK ETC) COULD BE
PRESCRIBED IN REGULATIONS UNDER
THE TRADE PRACTICES ACT 1974.
COMMISSION RESEARCH TO
DETERMINE EXACTLY HOW PACKS
SHOULD BE DESIGNED TO MINIMISE
APPEAL TO YOUNG PEOPLE

40. Continuing research
• Australia (Wakefield et al)
• Canada (Hammond et al)
• New Zealand (Hoek et al)
• US (FDA et al)
• UK (Various….)

41. Review in Addiction, 2008
21

42. WHO Framework Convention
on Tobacco Control
22

43. 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

44. GOVERNMENT
• Release September 1st 2009
• Minister Roxon – “We are killing people by
not acting”

45. Action On Tobacco After Report
Current/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.

46. Action After Report on Tobacco - 2
Federal Government
Progressive Implementation of Taskforce
recommendations – 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

47. APRIL 29, 2010

49. 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.

50. The Political Scene
Countering the industry lobby – Simon
Chapman paper

51. REPUTATION INSTITUTE - Global Industry Results
Consumer Products 73.8
Electrical & 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

52. 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

53. 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

54. Two Episodes

57. Midnight Emails

66. Opposition Leader Tony Abbott has said he would support any move to curb smoking
rates, but he has refused to back the government's 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 The
Sunday Age last week. Dr Washer, who spent 26 years as a medical practitioner
before moving into federal politics, gave a blunt assessment of the tobacco industry's
strategy.
''All this talk of chop chop and crime gangs sounds like bullshit to me. The tobacco
industry is jumping up and down because they're worried about their businesses. I
support these reforms unequivocally and whatever my party decides to do, I don't give
a shit,'' Dr Washer said.
He said smoking killed about 19,000 Australians each year, and governments had a
moral responsibility to implement any measure that could stop young people from
taking up the habit
The Age, May 22, 2011

68. 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

69. 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

70. WHAT MADE THE
DIFFERENCE? - 3
• Media
• Public opinion
• International support
• Principled politicians

71. 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…..

74. Tobacco industry reaction to plain
packaging 2010-2011, Australia
What other nations can expect
Prof Simon Chapman
School of Public Health University of Sydney
Twitter: simonchapman6

75. Highly recommended
2

76. 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

77. 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

78. Argument 1: Never been done before .. therefore “no evidence”
Should we
never do
anything for
the first time?
5

79. Other firsts in public health
 Other firsts
 Seat belts • “Great argument: it's never been
done before, therefore you
 RBT shouldn't do it. This is the poor
little stupid Australia
 Advertising bans argument. We should always
merely follow the lead of other
 Vaccination countries because we're not
smart enough to dream up
 Lead free petrol anything good ourselves.. But if
the idea's 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

80. 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)

81. Our 3 most powerful arguments
1. Packaging =
centrepiece of
promotions: we are
finishing the job of
banning all advertising
2. It will have its greatest
impact with the next
generation by reducing
uptake, not current
smokers
3. If it “won’t work”, then
why is the global
tobacco industry having
weapons’ grade
apoplexy?
8

82. Argument 2: ““no evidence” (of any sort) that it will work
BAT advertisement 31 page dossier
9

83. Best evidence found in industry sources
10

84. Argument 3: it will make packs easier to counterfeit …
Current packs are
VERY easy to copy
already!
11

85. 12

86. Argt 4: Illicit trade will boom
16% (>1 in 6) of all tobacco
consumed = illicit.
13

87. Argument 4: Illicit trade will boom, prices will fall, more kids will
smoke
If prices fall, government can put up tax within 24hrs
14

88. Argument 5: All packs “look the same”
Shopkeeper & customer confusion
http://www.plain-packaging.com
15

89. …but it may well decrease transaction times 
16

90. Argument 6: Nanny state
17

91. 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

92. Argument 8: We need 17 months AFTER legislation to comply
19

93. Legal arguments: does it violate the Australian constitution?

94. 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.

95. 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.

96. 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?

97. Timeline: Philip Morris Hong Kong-Australian bilateral treaty
Date Event
29 April 2010 • Australian Government announces its decision to implement
plain packaging.
remainder of 2010 • Objections and complaints made by Philip Morris entities to
and 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.

98. The hunt for the $3billion/year
factoid
British
American
Tobacco
25

99. Between 1999 and 2003 the average annual fall
in total dutied cigarettes was just 2.6%.
The most sales have ever fallen in one year was
just shy of 10% in 1999

100. 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

101. Comparison with packaging of prescribed pharmaceuticals
28

102. (then) Health Minister , Nicola Roxon,
at UN Summit on NCDs, 2011
29