Plain packaging and public health_qualitative

Plain packaging and public health:The case of tobacco ☆

Karine Gallopel-Morvan a ,?,Patrick Gabriel b ,??,Marine Le Gall-Ely c ,???,Sophie Rieunier d ,????,Bertrand Urien b ,??

EHESP School of Public Health,CREM,France b

IAE,ICI,University of Brest,France c

UFR DSEG,IREA,University of South Brittany,France d

IAE,University of Paris 1-Sorbonne,GREGOR,France

a b s t r a c t

a r t i c l e i n f o Article history:

Received 1February 2012

Received in revised form 1July 2012Accepted 1August 2012

Available online 23September 2012Keywords:

Social marketing Tobacco

Plain packaging Color

Since the tobacco industry has been stripped of most of its marketing mix,the cigarette package has become an increasingly important advertising tool.However,plain packaging could make it less attractive (by removing design elements such as logos and colors,leaving only the brand name in a standardized typeface and size).To investigate the impact of the plain pack,a qualitative study based on 6focus groups was conducted with 50French individuals aged between 15and 45.Its ?ndings suggest that plain packaging signi ?cantly reduces the pack's appeal and bene ?ts public health policies if combined with pictorial warnings on both sides and if the color of the plain pack is carefully chosen.

1.Introduction

Smoking-related diseases are responsible for nearly 5million deaths worldwide each year.To tackle this problem,the World Health Organiza-tion (WHO)recommends plain packaging —cigarette packages stripped of all distinctive tobacco brand markers (slogan,logo,color,etc.).Brand names are printed in a black,standardized typeface,while the color of the plain pack itself should be made as unattractive as possible.Plain packaging will be introduced for the ?rst time in 2012in Australia.

The existing literature on plain packaging provides evidence of its effectiveness compared to branded packaging,but there have been no studies to date on the impact of different plain pack colors.This article addresses this issue by exploring the impact of plain packaging as a new prevention tool,speci ?cally by testing different plain pack back-ground colors.After an overview of key research to date on plain

packs and how color affects consumer responses,the results of an ex-ploratory qualitative study are presented and discussed.2.Plain packaging:is it effective?

Existing research on plain packaging indicates a greater recall rate for health warnings on plain packs than on current packs (Beede &Lawson,1992;Goldberg,Lie ?eld,Madill,&Vredenburg,1999).Plain packs are also detrimental to a smoker's image as they render the latter less cool,less attractive,less friendly and older (Germain,Wake ?eld,&Durkin,2010;Madill-Marshall,Goldberg,Gorn,Liefeld,&Vredenburg,1996;Wake ?eld,Germain,&Durkin,2008).For their part,Hoek,Wong,Gendall,Louviere,and Cong (2011)demonstrate that plain packs tend to promote cessation activities in young smokers.

In spite of the interesting effects produced by plain packaging (as op-posed to branded packaging),important areas have not been explored.

To date,there has been no research on the effectiveness and the im-pact that different colors have on plain tobacco packaging,even though it is well documented that color can alter the inherent meaning of an object or situation with which it is associated,impact emotions and preferences and predict future purchasing behavior (Adams &Osgood,1973;Babin,Hardesty,&Suter,2003;Clarke &Costall,2008;Singh,2006).In particu-lar,researchers notice that packaging color affects sensory and hedonic ratings,signals product's attributes and determines the consumer's ?nal perception of the product inside the package,which in turn in ?u-ences price and quality perceptions (Ares &Deliza,2010;Kerfoot,Davies,&Ward,2003).Tom,Barnett,Lew,and Selmants (1987)note that “advertisements for menthol cigarettes are awash in greens,blues,

Journal of Business Research 66(2013)133–136

☆The authors thank Institut National du Cancer (INCa),the Mission Interministérielle de Lutte contre les Drogues et Toxicomanies (MILDT)and Institut National de la Santéet de la Recherche Médicale (INSERM).

?Corresponding author at:K.Gallopel-Morvan,EHESP,Av Professeur Léon Bernard,CS 74312,35043Rennes Cedex,France.

??Correspondence to:IAE de Brest,ICI,12,rue Kergoat,29238Brest,France.

???Correspondence to:M.Le Gall-Ely,UFR DSEG —IMABS,1,rue de la Loi,56017Vannes Cedex,France.

????Correspondence to:S.Rieunier,IAE de Paris,GREGOR,21,rue Broca,75005Paris,France.

E-mail addresses:karine.gallopel-morvan@ehesp.fr (K.Gallopel-Morvan),

patrick.gabriel@univ-brest.fr (P.Gabriel),marine.legall@univ-ubs.fr (M.Le Gall-Ely),sophie.rieunier@univ-paris1.fr (S.Rieunier),bertrand.urien@univ-brest.fr (B.

https://www.360docs.net/doc/1f18189631.html,/10.1016/j.jbusres.2012.09.004

Contents lists available at SciVerse ScienceDirect

Journal of Business Research

and whites to communicate to consumers the refreshing and soothing nature of the product”.Grimes and Doole(1998)point out that the psy-chological association the consumer makes with the pack's red color strengthens Marlboro's brand identity(i.e.images of cowboys and adventurers).

Regarding plain packs,researchers have only considered white or brown,which may not be the best colors to discourage consumers. For instance,Aslam(2006)emphasizes that in Anglo-Saxon countries (Australia and the USA),white symbolizes purity and happiness. Madden,Hewett,and Roth(2000)also indicate that in a European country(Austria)white has calming,peaceful,gentle and pleasant con-notations.Brown,on the other hand,is perceived as one of the most suitable colors for tobacco due to the congruency between the color of the pack and the product inside it(Jacobs,Keown,Worthley,&Kyung, 1991).Furthermore,a study carried out on the effect of color change reveals that any incongruity between product category and packaging color has a negative effect on product attractiveness(Garber,Burke,& Jones,2000).In different cultures,gray might be more suitable for plain packaging.First,gray is associated with speci?c meanings like“hospital”in America,Japan,Korea,and China(Jacobs et al.,1991)and therefore illness.Second,gray is associated with negative meanings for the Chinese who consider gray as“lifeless,old,and shapeless”(light gray)and “oppressive,no future,disagreeable”(dark gray)(Saito,1996).Finally gray is the color French consumers dislike the most(Ou et al.,2010).

In view of these gaps in the literature,this study investigates the impact of plain tobacco packaging with different base colors vs.current packaging.

3.Results of the qualitative study

An exploratory study was conducted in France.Six round tables(a total of50persons)were conducted using the following discrimina-tory variables:(i)participant state(26smokers out of50subjects), (ii)gender(an equal number of male and female subjects),and(iii)age bracket(15–24:17subjects,25–34:17subjects and35–45:16subjects).

Test subjects examined the following sets of Marlboro packages(this brand was chosen as it is the leading brand in France):

-four different Marlboro packages(Table1):(i)one current pack vs.

one plain gray pack with pictorial warnings(photo of a throat cancer and of a doctor helping a smoker to quit)on both faces.These are WHO-recommended warning formats that are used in,but not exclusively,Canada,Australia,New Zealand,and Uruguay;(ii)one current pack vs.one plain gray pack without pictorial warnings on the front.The current pack features the words“smoking kills”on the front and a photo of a throat cancer on the back(the format of warnings used in France since April2011);

-three plain Marlboro packs of different colors(white,gray and brown) with a pictorial warning on the back(photo of a throat cancer) (Table2).

A session guide that covered opinions and attitudes toward these dif-ferent packs structured the round table discussions.The focus groups lasted2h.The interviews were recorded,full verbatim transcripts were produced and a thematic content analysis was performed afterwards, which involved transcribing and then manually codifying the text.This consisted in data reduction and content analysis(categorizing and indexing data into empirically identi?ed themes).After analysis of the two group interviews,a coder(who carried out the subsequent coding) and a researcher worked together to establish a coding matrix.Another researcher,who recoded the data from the two focus groups,tested reli-ability.Inter-rate reliability was high(over85%).For each category the number of occurrences(total number of repetitions of a group of words/adjectives with the same meaning)and the number of individuals who used this group of words/adjectives was counted.3.1.Perception of the four packs:current Marlboro packs vs.plain gray packs

The two plain gray packs are rated more effective prevention-wise than the two current Marlboro packs(256negative associations for the former compared to56for the latter):

–plain gray packs are rated less attractive than the current packs (54citations,26individuals,mainly males);

Table2

The three plain packs used in the study.

Plain brown pack Plain white pack Plain gray pack

134K.Gallopel-Morvan et al./Journal of Business Research66(2013)133–136

–plain gray packs evoke images of graves and death,they are sad,unappealing,commonplace and “all the same ”(42citations,16indi-viduals);they discourage people from both purchasing cigarettes and smoking (25citations,17individuals,especially non-smokers and males):“Well,I think that gray makes you think of cigarette smoke;gray is a bland color,kind of lifeless and sad ”(non-smoker,28years old,female)–plain gray packs do not look like cigarette packs;they look poisonous and more dangerous (17citations,8individuals),especially plain gray packs with pictorial warnings on both faces:“Sickly …It's like holding something that's toxic.Er,I mean,you sort of pick it up reluctantly –even the plain gray packs with the ‘throat ’images and the doctor –it's an uneasiness that really gets under your skin ”(non-smoker,43years old,male).

However,with current Marlboro packs,respondents tend to refer to the marketing image generated by the brand;especially for the pack with a pictorial warning only on the back (88cases in total,mainly non-smokers):

“For me,it's the stereotypical cigarette.It's,er,Marlboro.It's the cowboy ”(smoker,25years old,male).

Furthermore,when respondents are asked to choose one of the four proposed packs that would put them off smoking and would motivate smokers to quit,people mainly cite the two plain gray packs as opposed to the two current packs (76citations for the plain gray packs vs.21for the current pack with pictorial warnings on both sides).

Despite these reactions,some respondents like the plain gray packs (especially the one with the textual warning on the front face of the pack)because they ?nd them trendy (18citations in total,8individuals,only females,more smokers than non-smokers).

Finally,16respondents state that no pack,regardless of its appearance,would be effective in motivating cessation behaviors,while 11individuals state that any pack could achieve this goal because pictorial warnings instill fear.

3.2.Perception of the three plain packs in different colors

Some respondents perceive the three gray,brown and white packs with pictorial warnings on the back as understated,attractive,re ?ned,trendy,elegant and as fashion accessories and fashionable (15individuals,especially females).Conversely,some respondents

rate the packs as unattractive and state that they do not look like cur-rent cigarette packs (8individuals)and that they ignore all market-ing rules (5individuals,mostly smokers).

By analyzing the discussion points related to each color,these ?ndings suggest that the gray pack elicits more negative associations (ashes,death,dirtiness,mourning,unhealthy,etc.)than positive ones (Table 3).By contrast,the brown pack generates more positive reac-tions (reassuring,brings to mind chocolate and the color of cigarettes,etc.)than negative ones,suggesting that this shade of brown may not be the ideal color for the plain pack:

“I think that it,er,it looks a lot neater,better …The others,they're more …they're less smart,more empty ”(non-smoker,20years old,male).Finally,while the plain white pack provokes more negative reactions than the brown pack,there are also many positive associations:a designer product,“purity ”,simplicity in design,etc.However,respondents'opin-ions on this pack are sharply divided.

Overall,the plain gray pack is associated with negative images (ugliness,neutrality,coldness,dirtiness)as opposed to positive im-ages (a designer product,re ?ned).

More generally,some respondents state that the pack's color is unimportant,does not incite cessation behaviors in smokers and that it is only what is inside the pack that counts (54citations,especially females and smokers):

“Well,no,er,it doesn't really bother me.None of them put me off.They're all the same as far as I'm concerned ”(smoker,18years old,female).

4.Conclusion and discussion

The results of this exploratory qualitative study form a social mar-keting program that aims to help public health policy makers in France act more effectively in preventing smoking.Furthermore,this study provides ample food for thought regarding future research in the same ?eld.

Its ?ndings suggest that the logos and colors on the Marlboro pack suf ?ce for image recall and brand capital.The introduction of plain packs could put an end to this priming effect under certain conditions.

First,plain packs with pictorial warnings only on the back (and thus not visible at ?rst glance)do not seem to be enough:pictorial warnings should appear on both faces.Here,pictorial warnings destroy brand image and they negatively impact intentions to buy the pack or to smoke the cigarettes inside.

Table 3

Reactions to the three plain packs used in the study.Plain white pack Plain brown pack Plain gray pack Positive perception:Negative perception:Positive perception:Negative perception:Positive perception:Negative perception:59cases/32individuals 60cases/34individuals a 70cases/40individuals

30cases/24individuals 27cases/12individuals

53cases/37individuals –Classy,clean,original,trendy,designer,light,pure,healthy,elegant –Makes you think of cosmetics

–Useful because you can write things on the pack's blank spaces

–Bland,ugly,empty,un ?nished,shows dirt easily,drab,neutral,repulsive

–Makes you think of medicine,the cigarettes taste bad

–Makes the “throat ”image stand out

–More effective for the prevention of smoking initiation

–Warm and reassuring color,attractive,colorful,re ?ned,trendy,happy,lively,original,pack motivates purchase –Makes the “throat ”image less overt –Makes you think of chocolate,candies,makes you feel hungry

–Reminds you of the Marlboro and Camel brands and cigarettes and cigars in general

–“Dressy ”:makes me think of suede

–Ugly,unclear,unhealthy,unattractive,impure,cheap,–Meat-like

–No motivation to smoke

–Designer,simplicity in design,luxury,

classy,silvery,elegant

–Ugly,neutral,unclear,unglamorous,sad,drab,cold,dirty,bland

–Evocative of mourning,death,ash,solemnity,bad times,unhealthy,smoke –No motivation to smoke nor for smoking initiation

Total individuals for the negative and positive perceptions can be more than 50(total number of individuals interviewed)because the respondents were able to express both negative and positive opinions for each pack.

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Secondly,reactions to the effectiveness of the plain pack concept varied among the respondents according to color.In a French cultural context,a plain gray pack appears to be the most effective option for public health purposes compared to brown or white packs.As there are cultural differences with respect to the meaning of colors,reactions of people toward gray may not be the same in other countries.

Thirdly,the impact of tobacco packs seems to vary according to smoking status:tobacco packs,plain or branded,which seem to have a weak in?uence on smokers'behaviors(quitting)whereas they seem to be effective on non-smokers in conveying a positive image of the brand (branded pack)or discouraging them to buy the pack(plain pack).A possible explanation is that smokers are addicted to nicotine and may need stronger stimuli than a plain pack to motivate them.These prelim-inary conclusions should be con?rmed with a quantitative study.

Despite these encouraging results,there are several limitations to this study.Some of the respondents'answers may be biased due to their un-derestimation of risks.Additionally,behavioral intentions were evaluated to the detriment of real behaviors.Within a qualitative approach extrap-olating the results also proved dif?cult because the sample population was not suf?ciently representative.

Nevertheless,this exploratory study presents innovative and more effective methods to combat tobacco use.Its?ndings suggest that the introduction of plain packs,possibly with pictorial warnings on both sides,would be a major public health initiative worth considering and one that is all the more appealing for governments since it is cost-free, unlike expensive,mass media,anti-smoking campaigns.

This exploratory work gives rise to further lines of research:as the impact of plain packs seems to differ according to their color,the various color associations at play in different cultural spaces and in different representative sample groups must be called into question.These spaces could be both tangible(e.g.countries)and intangible(e.g.social groups). More speci?cally,two lines of research have already opened up on the theme of color:

(i)First,one should bear in mind that an object's color can be de-

scribed multidimensionally in terms of hue,luminance and purity.

Hue corresponds to the position of the color in the color wheel and is determined by the color's dominant wavelength.Luminance is characterized by the intensity of the beam of light that makes the color lighter or darker accordingly.Purity indicates the degree of similarity between the color in question and the corresponding pure color.These colors are referred to as saturated or pure,or on the contrary,as diluted or pastel.To ignore this is to give up any hope of obtaining more subtle symbolic appreciations and evoca-tions.As far as the authors of the present study are aware,the dif-ferent multidimensional qualities of color,in as many cultural spatial contexts as possible,have not,to date,been taken into ac-count in plain pack studies.

(ii)The second line of research could deal with synesthesia,which can be de?ned as a subjective experience in which sensory perception modalities are usually accompanied by other perception modali-ties despite the latter's lack of excitation(Mattingley,Rich, Yelland,&Bradshaw,2001).In the case of tobacco,the interplay between the plain pack and the?avor of cigarettes inside should be studied in order to identify links between color and gustatory sensations.The latter,in its different forms(acidity,sourness,

bitterness,savory,sweet,metallic and spicy)may correspond with dominant colors as follows:green/savory;pink/sweet;yel-low/spicy and acidic.Gustatory expectations are so closely linked to color that eating food of an inappropriate color may cause a per-son to feel ill(Tysoe,1985).It is clear there is great potential for ap-plying research carried out in this?eld to the study of plain packs.

An interesting question would be whether there is a package color that generates the most repulsive gustatory associations for the cigarettes inside.

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