Medical Journal of Malaysia

MJM, Vol 70 Supplement 1 September 2015

Plain packaging for cigarettes - A Policy Brief

Tee Guat Hiong*, Lim Kuang Kuay*, Noran Naqiah Hairi**, Lim Kuang Hock*, Mohd Hazrin Hasim*, Faizah Paiwai*, Ahmad Nadzri Jai*, Norzawati Yeop*, Sayan Pan*, Jamsee Ongi*

*Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, **Julius Centre University of Malaya, Department of Social and Preventive Medicine, University of Malaya


Introduction: The global growing burden of smoking has prompted the introduction of plain packaging as an effective way to address the impact of colour and brand imagery on cigarette packages.  Plain packaging will help to reduce initiation of smoking for non-smokers and increase cessation of cigarette smoking among smokers.  The objective of this study was to determine the impact of plain packaging by decreasing the attractiveness of the cigarette packages.

Method: An online database searched was conducted for systematic reviews and reviews using PubMed, Cochrane Library, EMBASE, ProQuest Hospital Collection, MEDLINE and the OVID databases. The electronic search terms were ‘health warnings’, ‘individual cigarette sticks’, ‘smoking’, ‘health warning labels’, ‘graphic warnings’, health warning messages’, ‘packaging’, ‘labelling’ and ‘effective policy’.  The search was limited to all English papers published or made available in the last decade.

Results: Three systematic reviews and three primary studies met our selection criteria. These studies consistently substantiated the three core beneficial effects of plain cigarette packaging: 1) enhancing the salience of health warnings on plain cigarette packages by decreasing the attractiveness of the cigarette packages, 2) reducing misperceptions about the false health benefits and harmfulness of tobacco and 3) reducing the brand appeal to combat the marketing strategies such as media advertisement.

Conclusion: Evidence has shown that plain packaging will enhance the effectiveness of pictorial health warnings on cigarette packages.  This strategy will further reduce the smoking prevalence and initiation as well as increase smoking cessation amongst smokers, particularly amongst the susceptible youth and young adults.

Keywords: plain packaging, cigarette, smoking, pictorial health warning