Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom.
Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.
PLoS One. 2020 Aug 13;15(8):e0237513. doi: 10.1371/journal.pone.0237513. eCollection 2020.
The tobacco industry (TI) has used small cigarette pack sizes to encourage brand-switching and consumption, and to mitigate the impacts of tobacco tax increases. Since 2016, the European Union (EU) Tobacco Products Directive (TPD) specifies a minimum pack size of 20 cigarettes. We examined cigarette pack sizes in the EU and whether pack size composition differed between cheap and expensive price segments, as well as the impact of the revised TPD.
We conducted a longitudinal analysis of pricing data from 23 EU countries between 2006-2017. We examined pack sizes over time to assess the impact of the TPD, differences in pack size composition between cheap and expensive price segments, and compared gaps in median prices between products using actual and 'expected' prices (price if all packs contained 20 sticks).
Cigarette pack sizes changed over time, across the EU. The distribution of pack sizes varied between price segments, with small pack sizes especially frequent in the cheap segment of the cigarette market, but this varied over time and across countries. Packs of <20 cigarettes almost disappeared from the data samples after implementation of the TPD.
Implementation of the TPD appears to have virtually eliminated packs with <20 cigarettes, restricting their use by the TI. Our analysis suggests pack sizes have been used differentially across the EU. Country-level analyses on the industry's use of pack sizes, consumer responses, and evaluations of restricting certain pack sizes are needed to confirm our findings and strengthen policy.
烟草业（TI）一直使用小包装香烟来鼓励品牌转换和消费，并减轻烟草税增加的影响。自 2016 年以来，欧盟（EU）烟草产品指令（TPD）规定了最小包装尺寸为 20 支香烟。我们研究了欧盟的香烟包装尺寸，以及廉价和昂贵价格段之间的包装尺寸组成是否存在差异，以及修订后的 TPD 的影响。
我们对 2006-2017 年间 23 个欧盟国家的定价数据进行了纵向分析。我们随着时间的推移检查包装尺寸，以评估 TPD 的影响、廉价和昂贵价格段之间包装尺寸组成的差异，以及使用实际和“预期”价格（如果所有包装都包含 20 支香烟，则价格）比较产品之间的中位数价格差距。
随着时间的推移，欧盟的香烟包装尺寸发生了变化。包装尺寸的分布在价格段之间存在差异，小包装尺寸在香烟市场的廉价段特别频繁，但这种情况随着时间的推移和国家的不同而变化。在 TPD 实施后，<20 支香烟的包装几乎从数据样本中消失。
TPD 的实施似乎几乎消除了<20 支香烟的包装，限制了 TI 的使用。我们的分析表明，包装尺寸在欧盟被不同地使用。需要对各国烟草业使用包装尺寸、消费者反应和限制某些包装尺寸的评估进行分析，以证实我们的发现并加强政策。
