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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Effects of first exposure to plain cigarette packaging on smoking behaviour and attitudes: A randomised controlled study
Authors: Maynard, Olivia M
Leonards, Ute
Attwood, Angela
Bauld, Linda
Hogarth, Lee
Munafo, Marcus
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Keywords: Plain cigarette packaging
Standardised packaging
Randomised controlled trial
Issue Date: 13-Mar-2015
Publisher: BioMed Central
Citation: Maynard OM, Leonards U, Attwood A, Bauld L, Hogarth L & Munafo M (2015) Effects of first exposure to plain cigarette packaging on smoking behaviour and attitudes: A randomised controlled study, BMC Public Health, 15 (1), Art. No.: 240.
Abstract: Background: Plain packaging requires tobacco products to be sold in packs with a standard shape, method of opening and colour, leaving the brand name in a standard font and location. We ran a randomised controlled trial to investigate the impact of plain packaging on smoking behaviour and attitudes. Methods: In a parallel group randomised trial design, 128 daily smokers smoked cigarettes from their usual UK brand, or a plain Australian brand that was closely matched to their usual UK brand for 24hours. Primary outcomes were number of cigarettes smoked and volume of smoke inhaled per cigarette. Secondary outcomes were self-reported ratings of motivation to quit, cigarette taste, experience of using the pack, experience of smoking, attributes of the pack, perceptions of the health warning, changes in smoking behaviour, and views on plain packaging. Results: There was no evidence that pack type had an effect on either of the primary measures (ps > 0.279). However, smokers using plain cigarette packs rated the experience of using the pack more negatively (-0.52, 95% CI -0.82 to -0.22, p = 0.001), rated the pack attributes more negatively (-1.59, 95% CI -1.80 to -1.39, p < 0.001), and rated the health warning as more impactful (+0.51, 95% CI 0.24 to 0.78, p < 0.001). Conclusions: Plain cigarette packs reduce ratings of the experience of using the cigarette pack, and ratings of the pack attributes, and increase the self-perceived impact of the health warning, but do not change smoking behaviour, at least in the short term.
Type: Journal Article
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Rights: © 2015 Maynard et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Affiliation: University of Bristol
University of Bristol
University of Bristol
Institute for Social Marketing
University of New South Wales
University of Bristol

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