UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK.
Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK.
Addiction. 2020 May;115(5):802-809. doi: 10.1111/add.14770. Epub 2019 Aug 30.
Very few countries regulate maximum cigarette pack size. Larger, non-standard sizes are increasingly being introduced by the tobacco industry. Larger portion sizes increase food consumption; larger cigarette packs may similarly increase tobacco consumption. Here we consider the evidence for legislation to cap cigarette pack size to reduce tobacco-related harm.
We first describe the regulations regarding minimum and maximum pack sizes in the 12 countries that have adopted plain packaging legislation and describe the range of sizes available. We then discuss evidence for two key assumptions that would support capping pack size. First, regarding the causal nature of the relationship between pack size and tobacco consumption, observational evidence suggests that people smoke fewer cigarettes when using smaller packs. Secondly, regarding the causal nature of the relationship between reducing consumption and successful cessation, reductions in number of cigarettes smoked per day are associated with increased cessation attempts and subsequent abstinence. However, more experimental evidence is needed to infer the causal nature of these associations among general populations of smokers.
Cigarette pack size is positively associated with consumption and consumption is negatively associated with cessation. Based on limited evidence of the causal nature of these associations, we hypothesize that government regulations to cap cigarette pack sizes would positively contribute to reducing smoking prevalence.
很少有国家对香烟包装的最大尺寸进行监管。烟草业越来越多地推出更大、非标准尺寸的香烟。更大的份量会增加食物的摄入量；更大的香烟包装可能同样会增加烟草的消耗量。在这里，我们考虑通过限制香烟包装尺寸来减少与烟草相关的危害的立法证据。
我们首先描述了已经通过平装立法的 12 个国家对最小和最大包装尺寸的规定，并描述了可用的包装尺寸范围。然后，我们讨论了支持限制包装尺寸的两个关键假设的证据。首先，关于包装尺寸与烟草消费之间的因果关系，观察性证据表明，人们使用小包装时吸烟量减少。其次，关于减少消费与成功戒烟之间的因果关系，每天吸烟的数量减少与戒烟尝试的增加和随后的戒烟有关。然而，需要更多的实验证据来推断这些关联在吸烟者的一般人群中的因果关系。
香烟包装尺寸与消费呈正相关，而消费与戒烟呈负相关。基于这些关联的因果性质的有限证据，我们假设政府限制香烟包装尺寸的规定将积极有助于降低吸烟率。
