Standardised (or 'plain') packaging has reduced the appeal of smoking by removing imagery that smokers use to affiliate themselves with the brand they smoke. We examined whether changing the appearance of cigarette sticks could further denormalise smoking and enhance the negative impact of standardised packaging.
We conducted an online study of 313 New Zealand smokers who comprised a Best-Worst Choice experiment and a rating task. The Best-Worst experiment used a 2×3×3×6 orthogonal design to test the following attributes: on-pack warning message, branding level, warning size and stick appearance.
We identified three segments whose members' choice patterns were strongly influenced by the stick design, warning theme and size, and warning theme, respectively. Each of the dissuasive sticks tested was less preferred and rated as less appealing than the most common stick in use; a 'minutes of life lost' stick was the most aversive of the stimuli tested.
Dissuasive sticks could enhance the effect of standardised packaging, particularly among older smokers who are often more heavily addicted and resistant to change. Countries introducing standardised packaging legislation should take the opportunity to denormalise the appearance of cigarette sticks, in addition to removing external tobacco branding from packs and increasing the warning size.
This research output has an Altmetric Attention Score of 100. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 November 2025.
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#524,091
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Outputs from Tobacco Control
#269
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Outputs of similar age
#6,940
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Outputs of similar age from Tobacco Control
#6
of 34 outputs
Altmetric has tracked 33,000,238 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,954 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 36.2. This one has done particularly well, scoring higher than 93% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 433,364 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 98% of its contemporaries.
We're also able to compare this research output to 34 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 82% of its contemporaries.
