Cigarettes with on-product messages are one form of dissuasive cigarettes, which also include those printed with pictograms (such as a skull and crossbones) or those with wrapping papers dyed an unattractive colour, or a combination of these features.1 Preliminary studies have found that dissuasive cigarettes are expected to increase negative health perceptions of smoking, reduce positive smoking images and the perceived pleasure of smoking, decrease the desire to start smoking and increase the desire to quit.1
On-product health warnings are currently printed on cigarettes sold in Canada and Australia (see Sections 12A.1.2 and 12A.9.3). From 1st July 2025, cigarettes sold in Australia were required to show one of eight different warning messages in a white box printed on the filter. Examples of these cigarettes are shown in Figure 12A.7.1 and the full suite of messages can be found in Section 12A.1.2.
The usefulness of on-product messages in the forms recently introduced in Australia (see Section 12A.1.2 and Figure 12A.7.1) is discussed in this section. To date, studies of on-product messages have largely comprised of surveys of people’s reactions to prototypes of these sort of cigarettes used in experimental studies. More ‘real world’ research is necessary to determine the outcomes of the implementation of on-product messaging in Australia and Canada.
School students (aged 15 to 18) in Australia rated an on-product warning about mortality from smoking as more effective than the 2012 graphic health warnings, which were current at the time of the study. Participants in this study rated on-product messages based on how effective they thought each would be at discouraging smoking (in those who don’t smoke) and encouraging quitting for those who do.2 Similar results were found in a study of perceptions of on-product messaging among first year university students in Australia.3
A focus group study from Scotland found that people who smoke considered that on-product messages would prolong the health messaging after cigarettes are taken out of a pack. Cigarettes with health messages were considered embarrassing. Younger people in this study reported considering reducing smoking if on-product messages were adopted.4
Studies in Scotland and Greece showed photos of cigarettes with on-product messages to people who smoked.5 These were 1) ‘Each puff reduces your life expectancy by …’ together with graphics showing 1–11 minutes progressing down the length of the tobacco stick, and 2) ‘toxic constituents’. Study participants reported increased quitting intentions after viewing the photos.5 In an experiment in New Zealand, people were less likely to choose a cigarette with a dissuasive message (“smoking kills”, or “minute of life lost”) than a standard cigarette. Older people (above the age of 55), more so than younger people who smoke, rated these cigarettes as less appealing indicating that the use of dissuasive messages may be a particularly useful intervention for older consumers.6 The ‘minutes of life lost’ message was highly rated in these studies. The ‘minutes of life lost’ message is necessarily printed on the tobacco stick wrapper, but is not suitable for inclusion on filter.
Some studies have compared the responses to different types of messages on cigarette sticks. A study from Saudi Arabia found that 35% of people thought that messages on the social and financial consequences of smoking would be effective in prompting quitting, while 28% of people thought that statistics on mortality would be effective on-product messages.7 A survey conducted in Australia, Canada, the UK and US found that the on-product warnings describing the financial costs of smoking and the effect of smoking on others were considered most effective, compared to current pack warnings (these being the 2012 graphic health warnings in Australia at the time, described in Section 12A.2.4).8 Messages on the themes of risk of mortality from smoking, minutes of life lost and planning to quit were also considered more effective than the pack warnings of the time.8 A study from the Netherlands found the young people who don’t smoke rated the on-product message ‘cancer, heart disease, stroke’ (diseases that have been discussed in graphic health warnings for many years as being caused by smoking) as least appealing.9
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References
1. Gallopel-Morvan K, Droulers O, and Pantin-Sohier G. Dissuasive cigarettes: which cues are the most effective at deterring young people from smoking? Public Health, 2019; 174:22-30. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31302393
2. Drovandi A, Teague PA, Glass B, and Malau-Aduli B. Australian school student perceptions of effective anti-tobacco health warnings. Frontiers in Public Health, 2018; 6:297. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30386764
3. Drovandi A, Teague PA, Glass B, and Malau-Aduli B. Australian university student perceptions of health messages on cigarette sticks. Health Communication, 2020; 35(4):456-64. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30676104
4. Moodie C, O'Donnell R, Fleming J, Purves R, McKell J, et al. Extending health messaging to the consumption experience: a focus group study exploring smokers' perceptions of health warnings on cigarettes. Addiction Reseach & Theory, 2020; 28(4):328-34. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32939185
5. Hassan LM and Shiu E. No place to hide: two pilot studies assessing the effectiveness of adding a health warning to the cigarette stick. Tobacco Control, 2015; 24(e1):e3-5. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24335476
6. Hoek J, Gendall P, Eckert C, and Louviere J. Dissuasive cigarette sticks: the next step in standardised ('plain') packaging? Tobacco Control, 2016; 25(6):699-705. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26676026
7. Al-Ahmadi AF, Almatrafi MA, Ali AK, Alsaedi OH, and Al-Zalabani AH. Perceptions of health warnings on cigarette sticks among the adult population in Al-Madinah, Saudi Arabia: A cross-sectional survey. Tobacco Induced Diseases, 2024; 22. Available from: https://www.ncbi.nlm.nih.gov/pubmed/38384733
8. Drovandi A, Teague PA, Glass B, and Malau-Aduli B. Smoker perceptions of health warnings on cigarette packaging and cigarette sticks: A four-country study. Tobacco Induced Diseases, 2019; 17:23. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31582934
9. van Mourik DJA, Nagelhout GE, Poole NL, Willemsen MC, Candel M, et al. Non-smoking adolescents' perceptions of dissuasive cigarettes. Addictive Behaviors Reports, 2022; 15:100433. Available from: https://www.ncbi.nlm.nih.gov/pubmed/35620217