Cigarette packaging as a commercial determinant of smoking: A thematic analysis of Filipinos’ perception of graphic health warnings and plain packaging in the Philippines

The Tobacco Control and Governance team of the Ateneo School of Government, through the Ateneo Policy Center, has recently published a study entitled "Cigarette packaging as a commercial determinant of smoking: A thematic analysis of Filipinos’ perception of graphic health warnings and plain packaging in the Philippines" in the peer-reviewed journal Social Science & Medicine. This study explores how cigarette packaging influences smoking behaviors and perceptions, contributing to the broader discourse on tobacco control policies in the country.

In line with Article 11 of the WHO Framework Convention on Tobacco Control, the Philippines implemented graphic health warnings (GHWs) on cigarette packs following the passage of the Graphic Health Warnings Law in 2014, which took effect in 2016. However, questions remain regarding their effectiveness in discouraging smoking.

Using a commercial determinants of health framework, this study analyzed data from open-ended questions in online and nationwide household surveys conducted in 2021. Respondents were shown mock-ups of cigarette packs reflecting the Philippines’ existing GHWs alongside plain packaging models from Singapore and Thailand. Researchers then conducted a thematic analysis to assess public perceptions of these packaging styles.

Key findings from 3,723 responses indicate that most respondents found current Philippine cigarette packs ineffective in discouraging smoking. In contrast, they viewed the GHWs from Singapore and Thailand as more impactful due to their larger warning sizes, reduced brand visibility, and inclusion of quitline information. Respondents highlighted the need for enhanced warning effectiveness through design modifications inspired by these regional models.

This study aligns with existing literature supporting the need for stronger tobacco control measures. Its findings suggest key policy recommendations, including:

• Prohibiting single-stick cigarette sales to reduce accessibility.
• Adopting plain packaging with larger GHWs to diminish brand appeal.
• Enhancing quitline visibility and accessibility to encourage smoking cessation.

By providing empirical evidence on Filipinos’ perceptions of cigarette packaging, this research underscores the urgency of policy reforms to strengthen tobacco control in the Philippines.

View the full paper here: https://doi.org/10.1016/j.socscimed.2024.117616