Impact of the removal of misleading terms on cigarette pack on smokers' beliefs about ‘light/mild’ cigarettes: cross-country comparisons

Aim This paper examines how smokers' beliefs about ‘light/mild’ cigarettes in Australia, Canada and the United Kingdom were affected by the removal of misleading ‘light/mild’ terms from packs. Design, setting and participants The data come from the first seven waves (2002–09) of the International Tobacco Control Policy Evaluation (ITC) Four-Country Survey, an annual cohort telephone survey of adult smokers in Canada, the United States, the United Kingdom and Australia (21 613 individual cases). ‘Light’ and ‘mild’ descriptors were removed in 2003 in the United Kingdom, in 2006 in Australia and in 2007 in Canada. We compare beliefs about ‘light’ cigarettes both before and after the bans, with those of smokers in the United States serving as the control condition. Measures Smokers' beliefs about ‘light’ cigarettes were assessed using a set of statements rated on a five-point ‘agree’–‘disagree’ scale. Findings The proportions of respondents reporting misperceptions about light cigarettes declined between 2002 and 2009 in all four countries. There were marked temporary reductions in reported misperceptions in the United Kingdom and Australia, but not in Canada, following the removal of ‘light/mild’ descriptors. Conclusions Removal of ‘light/mild’ descriptors and tar, nicotine and carbon monoxide yield information from cigarette packs is insufficient to effectively eliminate false beliefs. The combination of alternative descriptors and design features that produce differences in taste strength and harshness, independent of actual intakes, are sufficient to produce or sustain the same misbeliefs.