1. Plain packaging and tobacco cessation marketing 19 May 2016

2. Private and confidential – not for wider circulation Contents The move to plain packaging Learnings from Australia for marketing The current English quitting market Applying locally 2

3. The move to plain packaging in Australia 3 Sources: Australian adult smokers’ responses to plain packaging with larger graphic health warnings 1 year after implementation: results from a national cross- sectional tracking survey (Melanie Wakefield et al 2014) Has the introduction of plain packaging with larger graphic health warnings changed adolescents’ perceptions of cigarette packs and brands? (Victoria White et al, 2015 http://tobaccocontrol.bmj.com/content/24/Suppl_2/ii42.full Reducing the appeal of tobacco Increase effectiveness of health harm messages Reducing the ability of packaging to mislead about smoking harms Change youth perception of the brand appeal Objectives Results for smokers More smokers: disliked the pack Found it less appealing Perceived lower quality Were less satisfied More smokers noticed health warnings Attributed quit motivation to the warnings Avoided specific harm images Increased proportion of those believing brands do not differ in harmfulness Reduced appeal for young people (12-17)

4. Private and confidential – not for wider circulation Learnings from Australia for marketing 4 Source: Association between tobacco plain packaging and Quitline calls: a population-based, interrupted time-series analysis. Young et al 2014. https://www.mja.com.au/journal/2014/200/1/association-between-tobacco-plain-packaging-and-quitline-calls-population-based AttitudesMotivation Demand for support Timing Dislike of the pack Lessening appeal Perceiving lower quality Noticing the health warnings more prominently Window of increased motivation and market-driven demand for support 78% increase in calls to Quitline in Australia (NSW and ACT) Peak occurred 4 weeks after the initial appearance of plain packaging Increases sustained over time (43 weeks)

5. Private and confidential – not for wider circulation5

6. The current quitting market in England

7. Reduction in smoking prevalence is slowing and there’s a decline in motivation to quit and in total numbers of quit attempts 7 SOURCE: Prevalence data from Smoking Toolkit Study all adults/all smokers aged 16+; % adults smoking tobacco (STS) … % of smokers aged 16+ making quit attempt in past year (STS) … Long term decline in smoking prevalence has stalled Decrease in prevalence of quit attempts generally % of smokers aged 16+ who want to quit (STS) … Steady decline in motivation to quit among smokers aged 16+

8. 8 E-cigarette retail sales are up over last year and use increasing among recent ex-smokers SOURCE: Prevalence data from Smoking Toolkit Study; Sales data from Sandtable analysis of Nielsen Sales Data to November 2015; % of current and recent ex-smokers using e-cigarettes (STS data) Retail sales for E-cigarettes increased over the past year Retail sales for NRT decreased over the same time period Among smokers, reported use of NRT also decreased (STS)

9. E-cigarettes are challenging cold turkey as a popular way to quit Use of quit aids in past 12 months 9 Source: STS/Nielsen

10. 10 Stoptober is still seen as a more effective way to quit than e-cigarettes. Stoptober and e-cigarettes are complementary to many BASE: All smokers (701), all current smokers (626), all aware of Stoptober (564), all current smokers who use e-cigarettes (131) SOURCE: LIKELY: How likely are you to do the following in the next couple of months.... / SUPBEL How believable do you think it is that …. / Q27 How much do you agree or disagree with the following statement 46% 31% Very or fairly likely to use to quit 68% 73% Believe it will help you quit * * Qualitative research found that non-users of products did not see e-cigarettes as barrier to signing up E-cigs *significant difference 25% of product users bought e-cigarettes for the first time because of Stoptober Four in 10 (41%) of Stoptober participants used e-cigarettes alongside Stoptober The PHE Report did heighten interest in, and consideration of using, e-cigarettes

11. Social participation 11

12. Social media and interaction with Stoptober has grown as an increasingly important part of the experience 12 Source: AWA1A Have you done any of the following online because of Stoptober this year?; AWA1C Overall, how important do you think social media was for your experience of Stoptober? Would you say…Base: All respondents 2014/15 (2175/2440); All using social media (1089/1472) % going online/using social media for 85% Of whom: % saying important part of experience At all important 58% Extremely/very 79% 52% 2015 2014 Sig increase from 2014 Qualitative research found a lack of awareness of the social media conversation, leading to some users missing out. For those using social media it is important to trigger and sustain quit attempts.

13. Stoptober 2015 sign-ups are down on previous years but quit attempts for all smokers increased to highest level yet with successful attempts increasing for first time 13 Source: Stoptober Registrations and TNS Evaluation BASE: (Claimed Participation) Current smokers and recent ex-smokers QUESTION: StopQA Have you made a quit attempt related to Stoptober this year? 2015: 16% reported making a Stoptober quit attempt 8% reported making attempt and still not smoking

14. Yorkshire and Humberside sign-ups maintained at higher levels. 2015 sign-ups were 30% higher than in 2012. 14 15,000 22,000

15. Private and confidential – not for wider circulation What this means for PHE tobacco cessation campaigns

16. Private and confidential – not for wider circulation What this means for the role of PHE tobacco cessation campaigns Window of increased motivation for at least 12 months after appearance on shelves Harvesting this demand to direct people to products and services Complementary role of different ways to quit including those who choose e-cigarettes Amplifying the trigger, directing people to support and sustaining the quit attempt

17. Private and confidential – not for wider circulation Applying locally to customer journeys Group A: Channels and touchpoints Group B: Key messages, creative content and call to action 15mins - Table discussion 10mins - Feedback

18. Thank you Emma.Corbett@phe.gov.uk 18 Private and confidential – not for wider circulation