Journal of Adolescent Health 54 (2014) 364
www.jahonline.org Letter to the editor
Delayed Tobacco Plain Packaging: How Much More Evidence Do We Need? To the Editors: The article by Czoli and Hammond [1], “Cigarette packaging: youth perceptions of ’natural’ cigarettes, filter references, and contraband tobacco,” provides an important perspective on how cigarette packaging and labeling can increase the appreciation of cigarettes and may develop and encourage misconception about the reduced harm of tobacco brands. I applaud the study for its sound methodological approach and for the integrated element of experimental design. However, there were two potential shortcomings: the non-representative sample and the social desirability bias. Both of those limitations were addressed by the authors. Moreover, the social desirability bias in this case can only drive the association to be underestimated; yet, the study has yielded a positive relation. In fact, the results of this research are consistent with previous observational and longitudinal studies that showed an association between exposure to tobacco labeling and smoking susceptibility among youth [2]. This study by Czoli and Hammond [1] should be an awakening call to policy makers who have failed so far to endorse plain packaging, despite the excess of evidence provided by the literature. No doubt, this highlights how politics can often interfere with public health. Australia has set a historical landmark by becoming the first country to adopt tobacco plain packaging. However, many national governments are reluctant in following the Australian example, and still seem to tango with the tobacco industry.
The industry has invested significant resources to target youth and promote brand image, and has developed a counterattack strategy to challenge plain packaging legislation on the basis of commercial free speech and the basis of intellectual property rights [3]. Public health policy makers will now know what approaches will be used against tobacco control policies, and set up their strategies and legislation accordingly, because plain packaging would be an effective tobacco control action. The research by Czoli and Hammond [1] will help enhance further construction of policies toward plain packaging in Canada and worldwide. Ziyad Ben Taleb, M.D., D.O.M.H., M.P.H. Department of Epidemiology, Florida International University Miami, Florida
References [1] Czoli CD, Hammond D. Cigarette packaging: youth perceptions of “natural” cigarettes, filter references, and contraband tobacco. J Adolesc Health 2013 Sep 4. pii:S1054-139X(13)00381-9. doi:10.1016/j.jadohealth.2013.07.016. [Epub ahead of print]. [2] Lovato C, Linn G, LF S, et al. Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours. Cochrane Database Syst Rev 2003;4. [3] Zarocostas J. Australia’s proposals on plain packaging set new global benchmark in anti-smoking efforts. BMJ 2011;342.
1054-139X/$ e see front matter Ó 2014 Society for Adolescent Health and Medicine. All rights reserved. http://dx.doi.org/10.1016/j.jadohealth.2013.11.005
www.jahonline.org Letter to the editor
Delayed Tobacco Plain Packaging: How Much More Evidence Do We Need? To the Editors: The article by Czoli and Hammond [1], “Cigarette packaging: youth perceptions of ’natural’ cigarettes, filter references, and contraband tobacco,” provides an important perspective on how cigarette packaging and labeling can increase the appreciation of cigarettes and may develop and encourage misconception about the reduced harm of tobacco brands. I applaud the study for its sound methodological approach and for the integrated element of experimental design. However, there were two potential shortcomings: the non-representative sample and the social desirability bias. Both of those limitations were addressed by the authors. Moreover, the social desirability bias in this case can only drive the association to be underestimated; yet, the study has yielded a positive relation. In fact, the results of this research are consistent with previous observational and longitudinal studies that showed an association between exposure to tobacco labeling and smoking susceptibility among youth [2]. This study by Czoli and Hammond [1] should be an awakening call to policy makers who have failed so far to endorse plain packaging, despite the excess of evidence provided by the literature. No doubt, this highlights how politics can often interfere with public health. Australia has set a historical landmark by becoming the first country to adopt tobacco plain packaging. However, many national governments are reluctant in following the Australian example, and still seem to tango with the tobacco industry.
The industry has invested significant resources to target youth and promote brand image, and has developed a counterattack strategy to challenge plain packaging legislation on the basis of commercial free speech and the basis of intellectual property rights [3]. Public health policy makers will now know what approaches will be used against tobacco control policies, and set up their strategies and legislation accordingly, because plain packaging would be an effective tobacco control action. The research by Czoli and Hammond [1] will help enhance further construction of policies toward plain packaging in Canada and worldwide. Ziyad Ben Taleb, M.D., D.O.M.H., M.P.H. Department of Epidemiology, Florida International University Miami, Florida
References [1] Czoli CD, Hammond D. Cigarette packaging: youth perceptions of “natural” cigarettes, filter references, and contraband tobacco. J Adolesc Health 2013 Sep 4. pii:S1054-139X(13)00381-9. doi:10.1016/j.jadohealth.2013.07.016. [Epub ahead of print]. [2] Lovato C, Linn G, LF S, et al. Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours. Cochrane Database Syst Rev 2003;4. [3] Zarocostas J. Australia’s proposals on plain packaging set new global benchmark in anti-smoking efforts. BMJ 2011;342.
1054-139X/$ e see front matter Ó 2014 Society for Adolescent Health and Medicine. All rights reserved. http://dx.doi.org/10.1016/j.jadohealth.2013.11.005
