TY - JOUR
T1 - Awareness and correlates of noticing changes to cigarette packaging design after implementation of the European Tobacco Products Directive
T2 - findings from the EUREST-PLUS ITC Europe Surveys
AU - Vardavas, Constantine I.
AU - Kyriakos, Christina N.
AU - Driezen, Pete
AU - Girvalaki, Charis
AU - Nikitara, Katerina
AU - Filippidis, Filippos T.
AU - Fernández, Esteve
AU - Mons, Ute
AU - Przewozniak, Krzysztof
AU - Trofor, Antigona C.
AU - Demjén, Tibor
AU - Katsaounou, Paraskevi A.
AU - Zatonski, Witold
AU - Willemsen, Marc
AU - Fong, Geoffrey T.
AU - Glahn, Andrea
AU - Nguyen, Dominick
AU - Radu-Loghin, Cornel
AU - Starchenko, Polina
AU - Tsatsakis, Aristidis
AU - Igoumenaki, Chryssi
AU - Papadakis, Sophia
AU - Papathanasaki, Aikaterini
AU - Tzatzarakis, Manolis
AU - Vardavas, Alexander I.
AU - Bécuwe, Nicolas
AU - Deaconu, Lavinia
AU - Goudet, Sophie
AU - Hanley, Christopher
AU - Rivière, Oscar
AU - Kiss, Judit
AU - Kovacs, Anna Piroska
AU - Castellano, Yolanda
AU - Fu, Marcela
AU - Nogueira, Sarah O.
AU - Tigova, Olena
AU - McNeill, Ann
AU - East, Katherine
AU - Hitchman, Sara C.
AU - Kahnert, Sarah
AU - Tountas, Yannis
AU - Behrakis, Panagiotis
AU - Gratziou, Christina
AU - Katsaounou, Paraskevi
AU - Peleki, Theodosia
AU - Petroulia, Ioanna
AU - Tzavara, Chara
AU - De Vries, Hein
AU - Hummel, Karin
AU - Nagelhout, Gera E.
AU - EUREST-PLUS consortium
N1 - Funding Information:
The EUREST-PLUS project has received funding from the European Union’s Horizon 2020 Research and Innovation Programme (Grant Agreement No 681109 to C.I.V.) and the University of Waterloo (G.T.F.). Additional support was provided to the University of Waterloo by a foundation grant from the Canadian Institutes of Health Research (FDN-148477). G.T.F. was supported by a Senior Investigator Grant from the Ontario Institute for Cancer Research. E.F. is partly supported by Ministry of Universities and Research, Government of Catalonia (2017SGR319) and by the Instituto Carlos III and co-funded by the European Regional Development Fund (FEDER) (INT16/00211 and INT17/00103), Government of Spain. E.F. thanks CERCA Programme Generalitat de Catalunya for the institutional support to IDIBELL.
Publisher Copyright:
© The Author(s) 2020. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Background: The European Tobacco Products Directive (TPD), which went into effect in May 2016, regulates packaging design and labelling of cigarettes and roll-your-own (RYO) tobacco. The aim of the current study was to examine whether smokers and recent quitters in six European Union (EU) countries (Germany, Greece, Hungary, Poland, Romania and Spain) reported noticing TPD-related changes to packaging, and correlates of noticing these changes. Methods: Cross-sectional data from the Wave 2 of the ITC 6 European Country Survey in 2018 after implementation of the TPD. Bivariate analyses included adult smokers (n ¼ 5597) and recent quitters (n ¼ 412). Adjusted logistic regression analyses were restricted to the subset of current smokers (n ¼ 5597) and conducted using SAS-callable SUDAAN. Results: Over half of smokers (58.2%) and 30% of quitters noticed at least one of five types of TPD-related pack changes. Over one-quarter of all respondents noticed changes to health warnings (30.0%), standardized openings (27.7%), minimum pack unit size (27.9%), and the removal of tar, nicotine and carbon monoxide information (26.7%) on packaging. Cross-country differences were observed across all measures, with noticing all pack changes markedly lower in Spain than the other countries. Correlates of noticing specific pack changes included sociodemographic characteristics, smoking behaviours and related to packaging. Conclusions: This is one of the first cross-country studies to examine the extent to which TPD changes to cigarette and RYO tobacco packaging are being noticed by smokers and recent quitters. Findings indicate that the majority of smokers noticed at least one type of pack change, but this varied across countries and sub-populations.
AB - Background: The European Tobacco Products Directive (TPD), which went into effect in May 2016, regulates packaging design and labelling of cigarettes and roll-your-own (RYO) tobacco. The aim of the current study was to examine whether smokers and recent quitters in six European Union (EU) countries (Germany, Greece, Hungary, Poland, Romania and Spain) reported noticing TPD-related changes to packaging, and correlates of noticing these changes. Methods: Cross-sectional data from the Wave 2 of the ITC 6 European Country Survey in 2018 after implementation of the TPD. Bivariate analyses included adult smokers (n ¼ 5597) and recent quitters (n ¼ 412). Adjusted logistic regression analyses were restricted to the subset of current smokers (n ¼ 5597) and conducted using SAS-callable SUDAAN. Results: Over half of smokers (58.2%) and 30% of quitters noticed at least one of five types of TPD-related pack changes. Over one-quarter of all respondents noticed changes to health warnings (30.0%), standardized openings (27.7%), minimum pack unit size (27.9%), and the removal of tar, nicotine and carbon monoxide information (26.7%) on packaging. Cross-country differences were observed across all measures, with noticing all pack changes markedly lower in Spain than the other countries. Correlates of noticing specific pack changes included sociodemographic characteristics, smoking behaviours and related to packaging. Conclusions: This is one of the first cross-country studies to examine the extent to which TPD changes to cigarette and RYO tobacco packaging are being noticed by smokers and recent quitters. Findings indicate that the majority of smokers noticed at least one type of pack change, but this varied across countries and sub-populations.
U2 - 10.1093/eurpub/ckaa057
DO - 10.1093/eurpub/ckaa057
M3 - Article
SN - 1101-1262
VL - 30
SP - III98-III107
JO - European Journal of Public Health
JF - European Journal of Public Health
IS - 3
ER -