Plain silly: why changing cigarette packets won't alter smoking rates

The public health establishment disseminates many "truths" about health, disease and lifestyle, but sadly, junk science is often the driving force behind these regulatory assaults on drinkers, smokers, gamblers and the overweight.

Exhibit A is the belief that tobacco advertising and promotion are the major reasons young people begin to smoke, and calls for the plain packaging of cigarettes in Australia and New Zealand.

Packaging, it is claimed, is merely an extension of advertising, and because advertising increases tobacco consumption, it is necessary to require all tobacco products to be sold in plain packaging.

Unfortunately, neither this belief nor this policy meets the standards of evidence-based policymaking, which requires decisions based on rigorous, systematic reviews of best practice - that is, interventions that work the best in reducing harm. Evidence alone, not theory or tradition, must drive policy.

The empirical record about tobacco advertising's effect on young people is decidedly mixed.

Large, independent studies have failed to find a statistically significant connection between tobacco advertising, consumption and youth smoking.

This lack of evidence is confirmed by the fact that countries that have had advertising bans for a quarter of a century or more have not experienced statistically large declines in youth smoking.

Consumption and prevalence data from 145 countries finds little evidence that the entire range of tobacco control measures, including advertising restrictions and bans, has a statistically significant effect on smoking prevalence in any nation.

Yet, Australia pushes ahead with draconian restrictions on tobacco brand promotion through legislation to require cigarettes be sold in plain packaging, and New Zealand's associate minister of health wants to follow its lead.

The evidence in support of plain packaging, just as for tobacco display bans, is embarrassingly thin. Most studies show that plain packaging will have no statistically significant effect on youth smoking. None of the so-called evidence about plain packaging provides compelling behavioural evidence that any young person started smoking after seeing conventional displays of cigarette products.

Other nations have rejected plain packaging. For example, Canada briefly considered plain packaging in 1994, but eventually took no action.

More recently, Britain seriously examined the concept in 2008 and 2009, but the then-Labour government concluded that there was insufficient evidence to justify legislation.