Standardized packaging and illicit tobacco use: A systematic review

INTRODUCTION: To systematically review the evidence regarding the effect of standardized packaging on illicit tobacco use. METHODS: Data sources were EMBASE, Web of Knowledge, Scopus, PsycInfo, Medline, and the British Library catalogue, from 01/01/1987 to 28/11/2016. Reference lists of included studies were hand searched for additional papers. Search strategies were based on the terms ‘tobacco’, ‘packaging’ and ‘illicit’. The search was restricted to English language references. Two reviewers screened titles and abstracts for empirical studies that addressed the topic of standardized packaging and illicit tobacco use. This resulted in 153 full text papers retrieved for screening. Following exclusions, ten papers were included in the review. Two reviewers’ extracted data using piloted standardized data extraction forms. Studies were assessed for quality and relevance using CASP. RESULTS: There was little homogeneity between included studies, so a narrative synthesis was employed. Of the relevant studies five reported smokers did not intend to or actually purchase further illicit tobacco following standardized packaging, although one suggested a small number of responders to online news felt smokers would be more inclined to purchase illicit tobacco, following standardized packaging. Two studies reported retailers did not intend to or actually increase sales of illicit tobacco following standardized packaging. Finally, two studies reported industry data on illicit tobacco were of poor quality and not supported by independent data. CONCLUSIONS: There were few studies examining tobacco standardized packaging and illicit trade, however those available showed no evidence that standardized packaging could lead to increases in illicit trade.