Plain packaging could reduce appeal of e-cigarettes to young people

Vaping — the use of e-cigarettes — is on the rise among young people as well as adults in the UK. In 2022, 8.3% of adults and 7% of youths aged 11-17 reported vaping. For people who are using e-cigarettes to help them to quit regular, tobacco-based cigarettes, there's a benefit. But, given that e-cigarettes still contain addictive nicotine, their growing use among teenagers is a concern. So how do you make vaping seem less appealing to young people, while not putting older smokers off switching to e-cigarettes? According to a new study in JAMA Network Open, one simple strategy could be to make all e-cigarette packaging similar to the type that has to be used for regular cigarettes in the UK.

Since 2016, by law, all tobacco-based cigarettes and rolling tobacco sold in the UK must be packaged in plain olive-green packs with a matte finish. The brand names must be printed in a standard font, and no brand imagery or logos are allowed. E-cigarettes don't have to meet this requirement, and are generally sold in brightly coloured packaging with prominent logos.

To explore the potential impacts of packaging on e-cigarette appeal, Eve Taylor at King's College London and colleagues surveyed 2,469 young people (aged 11-18) and 12,046 adults. Each participant was shown a total of three e-cigarette packs. One third of the participants saw regular branded packs from three different e-cigarette manufacturers. One third saw plain white packs; the originals had been digitally altered to remove the brand imagery and colour, and the brand name and contents were printed in a standardised font. The final third were also shown plain packaging but the pack colour was olive-green.

Participants were asked which of the three products they would be most interested in trying, or, for young people, which of the products "people their age" would prefer. They could pick a particular pack, respond "I don't know", or respond "None of these products".

The team found that, overall, 38.2% of the youths reported that people their age would be interested in trying one of the vaping products, while 32.2% said that people their age would have "no interest" in them. Overall, 7.9% of the adults said they would be interested in trying one of the products, while 87.7% said they had no interest.

However, participants' responses to these questions depended on which packaging they saw. When young people saw e-cigarettes in green packs, 35.8% said that people their age would have "no interest" in trying e-cigarettes — significantly more than the 28.7% who said people their age wouldn't be interested in the branded packs. In contrast, a higher proportion of adults reported having no interest in the regular branded packaging (88.1%) than the green packs (86.8%). The team's further analysis revealed that whether or not an adult was already a smoker or a vaper made no difference to these responses. For both adults and young people, there were no significant differences in "no interest" responses for plain white and branded packaging.

There are a few limitations to the study that are worth highlighting. The young people weren't asked about their own interest and may have been mistaken about what their peers would think. Also, because, the questions were different for youths and adults, the results for the two groups can't be directly compared. However, the finding that young people felt that e-cigarettes in green packaging would be less appealing is consistent with earlier work finding that young people regard green-packaged regular cigarettes to be less appealing than cigarettes in branded packs.

"This study suggests that standardised packaging measures may reduce the appeal of e-cigarettes among youths without reducing their appeal among adults," the team concludes.