Novel ways of using tobacco packaging to communicate health messages: Interviews with packaging and marketing experts

Background: Packaging is a powerful communications tool. In this study innovative ways in which cigarette packaging could potentially be used to communicate health messages, beyond the on-pack warnings and plain packaging, were explored. Methods: Face-to-face interviews were conducted with packaging and marketing experts (N=12) in the United Kingdom to explore novel ways of using the cigarette pack and cigarette to communicate with consumers: (1) Pack inserts, (2) A cigarette displaying a health warning, and (3) A pack playing an audio health message when opened. Participants were also asked to propose other ways, beyond those discussed, in which the pack could potentially be used to communicate health messages. Results: The on-cigarette warning was considered a powerful deterrent, thought to confront smokers, put off non-smokers, signal to youth that it is neither cool nor intelligent to smoke, and prolong the health message. Inserts were considered an appropriate supplement to the on-pack warnings, particularly if they featured gain-framed messages, and helpful for engaging smokers contemplating quitting. It was suggested that the pack with an audio health message may badger a regular smoker to the point of quitting, but the concern was that it was annoying and could lead smokers to decant their cigarettes into an alternative carrier. A number of other options for communicating with consumers were proposed. Conclusions: Pack inserts and cigarettes displaying health messages are two viable options available to regulators for supplementing the warnings on the outside of packs and thus extending health communication with consumers.