The Effect of Plain Cigarette Packaging on Implicit Attitudes

The Effect of Plain Cigarette Packaging on Implicit Attitudes

 Saadet Merih Cengel1*, Onur Noyan1, Nesrin Dilbaz1

 1Uskudar University.

 Rationale: The significance of this research stems from the impact implicit attitudes have on smoking behavior, where positive implicit attitudes can result in a greater likelihood of smoking behavior. Even though it has previously been argued that implicit attitudes can drive addictive behavior there is a lack of research on whether cigarette packaging has an influence on implicit attitudes.

Objectives: The purpose of this study was to examine the effect of plain cigarette packaging and designed/logo cigarette packaging on implicit attitudes.

Methods: Implicit attitudes towards cigarette packaging were assessed by means of the Brief Implicit Association Test (BIAT). A questionnaire was conducted to assess sociodemographic and smoking behavior. The Fagerström Test for Nicotine Dependence (FTND) was used to assess level of dependence. The sample consisted of 264 participants.

Results: BIAT indicate a significant association between designed/logo cigarette packaging and positive implicit attitudes (Mean d-score > .15). Cigarette packaging design’s influence on implicit attitudes is positive (Mean d-score = .22), where there is a slight association between designed/logo packaging and positive implicit attitudes.

Conclusions: When compared with plain packaging, designed/logo cigarette packaging leads to positive implicit attitudes. These findings support the effectiveness of plain packaging regulations where the removal of color, design and logo from cigarette packaging will decrease positive implicit attitudes formed by cigarette packaging.

Keywords: implicit attitudes, plain packaging, cigarette packaging, addiction

Free Full-text PDF

How to cite this article:

Saadet Merih Cengel, Onur Noyan, Nesrin Dilbaz. The Effect of Plain Cigarette Packaging on Implicit Attitudes. International Journal of Addiction Research and Therapy, 2021; 4:24. DOI: 10.28933/ijart-2020-12-1305


1. Daube, M., Eastwood, P., Mishima, M., & Peters, M. (2015). Tobacco plain packaging: The Aus-tralian experience. Respirology, 20(7), 1001-1003. doi:10.1111/resp.12621
2. Morgenstern, M., Isensee, B., & Hanewinkel, R. (2013). Seeing and Liking Cigarette Advertise- ments: Is There a “Mere Exposure” Effect? European Addiction Research, 19(1), 42-46. doi:10.1159/000339836
3. Cin, S. D., Gibson, B., Zanna, M. P., Shumate, R., & Fong, G. T. (2007). Smoking in Movies, Implicit Associations of Smoking With the Self, and In-tentions to Smoke. Psychological Science, 18(7), 559-563. doi:10.1111/j. 1467-9280.2007.01939.x
4. Isaacs, S. L., & Schroeder, S. A. (2004). Class — The Ignored Determinant of the Nation’s Health. New England Journal of Medicine, 351(11), 1137-1142. doi:10.1056/nejmsb040 329
5. Durkin, S. J., Biener, L., & Wakefield, M. A. (2009). Effects of Different Types of Antis- mo-king Ads on Reducing Disparities in Smoking Cessation Among Socioeconomic Subgroups. American Journal of Public Health, 99(12), 2217-2223. doi:10.2105/ajph.2009.161638
6. Kayaalp, E. (2015). Remaking Politics, Markets, and Citizens in Turkey : Governing Through Smoke. doi:10.5040/9781472594587
7. Greenland, S. J. (2016). The Australian experience following plain packaging: The impact on tobacco branding. Addiction, 111(12), 2248-2258. doi:10.1111/add.13536
8. Mutlu, F. S., Ayranci, U., & Ozdamar, K. (2006). Cigarette smoking habits among men and women in Turkey: A meta regression analysis. Iranian Journal of Public Health, 7–15.
9. Ozcebe, H., Bilir, N., Inal, E., Beşer, E., Çan, G., Kiraz, E., . . . Çalıkoğlu, E. (2015). The Percep-tions of Adults on Cigarette Sales to Minors. European Journal of Public Health, 25(Suppl_3). doi:10.1093/eurpub/ckv176.242
10. White, V. (2003). How has the prevalence of cig-arette smoking changed among Australian adults? Trends in smoking prevalence between 1980 and 2001. Tobacco Control, 12(90002), 67ii-74. doi:10.1136/tc.12.suppl_2.ii67
11. Tugrul, T. (2015). The Impacts of Fear and Disgust on the Perceived Effectiveness of Smoking Warning Labels: A Study on Turkish University Students – Tugba Orten Tugrul, 2015. Retrieved December 12, 2020, from
12. Houwer, J. D. (2001). A Structural and Process Analysis of the Implicit Association Test. Journal of Experimental Social Psychology, 37(6), 443-451. doi:10.1006/jesp.2000.1464
13. Perugini, M., Richetin, J., & Zogmaister, C. (2010). Prediction of behavior. In B. Gawronski & B. K. Payne (Eds.), Handbook of implicit social cogni-tion: Measurement, theory, and applications (p. 255–277). The Guilford Press.
14. Andrews, J. A., Hampson, S. E., Greenwald, A. G., Gordon, J., & Widdop, C. (2010). Using the Implicit Association Test to Assess Children’s Implicit Attitudes Toward Smoking. Journal of Applied Social Psychology, 40(9), 2387-2406. doi:10.1111/j.1559-1816.2010.00663.x
15. Spruyt, A., Lemaigre, V., Salhi, B., Gucht, D. V., Tibboel, H., Bockstaele, B. V., . . . Nackaerts, K. (2015). Implicit attitudes towards smoking predict long-term relapse in abstinent smokers. Psy-chopharmacology, 232(14), 2551-2561. doi:10.1007/s00213-015-3893-2
16. Kahler, C. W., Metrik, J., Lachance, H. R., Ram-sey, S. E., Abrams, D. B., Monti, P. M., & Brown, R. A. (2008). Addressing heavy drinking in smoking cessation treatment: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 76(5), 852-862. doi:10.1037/a00 12717
17. Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerstrom, K. (1991). Fagerström Test for Cigarette Dependence. PsycTESTS Dataset. doi:10.1037/t03773-000
18. Greenwald, A. G., Mcghee, D. E., & Schwartz, J. L. (1998). Implicit Association Test. PsycTESTS Dataset. doi:10.1037/t03782-000
19. Nosek, B. A., Bar-Anan, Y., Sriram, N., Axt, J., & Greenwald, A. G. (2014). Understanding and using the brief implicit association test: Recommended scoring procedures. PloS One, 9(12), e110938.
20. Sriram, N., & Greenwald, A. G. (2009). Brief Im-plicit Association Test. PsycTESTS Dataset. doi:10.1037/t59740-000
21. Greenwald, A. G., Nosek, B. A., & Banaji, M. R. (2003). Understanding and using the Implicit Association Test: I. An improved scoring algo-rithm. Journal of Personality and Social Psy-chology, 85(2), 197-216.
22. Hughes, J. R., & Naud, S. (2016). Perceived role of motivation and self-efficacy in smoking ces-sation: A secondary data analysis. Addictive Behaviors, 61, 58-61. doi:10.1016/j.addbeh. 2016.05.010
23. Mackereth, P. (2015). Plain packs and more: Towards a smoke-free future. British Journal of Nursing, 24(5), 256-256. doi:10.12968/bjon. 2015.24.5.256
24. Hammond, D. (2010). “Plain packaging” regula-tions for tobacco products: The impact of standardizing the color and design of cigarette packs. Salud Pública De México, 52. doi: 10.1590/s0036-36342010000800018