Call for evidence outcome

Standardised packaging for all tobacco products: analysis of responses

Updated 10 July 2026

Introduction

From 5 November 2024 to 28 January 2025, the UK government and the devolved governments of Scotland, Wales and Northern Ireland ran a 12-week UK-wide call for evidence on standardising the packaging and introducing pack inserts for:  

• all tobacco products (other than cigarettes and hand rolling tobacco)
• cigarette papers
• herbal smoking products
• heated tobacco devices

The call for evidence asked about the prevalence, use, health harms and current packaging of these products. It also asked for evidence of standardised packaging and pack inserts being introduced for these products and the impact of this, including on use, health, businesses, the environment and enforcement.

Pack inserts are positive quit-themed messages and advice inside tobacco packets to help smokers to quit.

The call for evidence forms part of our work to legislate to mandate pack inserts in these products, following the government’s response to the Mandating quit information messages inside tobacco packs consultation published on 5 November 2024. In this consultation, we stated that to do this, we would first consider introducing more stringent packaging requirements for the different products, wherever possible. 

Overview of responses

The call for evidence received 48 responses. Of these responses, 4 were from individuals sharing personal views, 6 were from individuals sharing professional views and 38 were from organisations, of which:

• 14 were from the public sector
• 11 were from the not-for-profit sector
• 12 were from the private sector
• 1 organisation did not disclose its sector

The call for evidence was UK-wide, and table 1 shows the breakdown of respondents by geography. Respondents could select multiple answers; for example, an organisation may operate in England, Wales and Scotland. Each response has been counted individually, so the total number of geographical responses is higher than the number of respondents to the call for evidence.

Table 1: geographical breakdown of respondents

Location	Number of responses
All of the UK	18
England	20
Wales	6
Scotland	3
Northern Ireland	1
Not applicable or did not answer	6

The UK is a party to the World Health Organization Framework Convention on Tobacco Control and has an obligation to protect the development of public health policy from the vested interests of the tobacco industry. To meet this obligation, we asked all respondents to disclose whether they had any direct or indirect links to, or received funding from, the tobacco industry, and noted that their responses would be published. Thirteen respondents disclosed that this was the case.

We have reviewed all the evidence provided and summarised the main themes in this response. We have highlighted in our analysis where evidence has been funded by the tobacco industry. We have also highlighted where themes were predominantly raised by respondents with links to the tobacco industry.

We received a mix of content in the call for evidence responses. Most responses were supported by data and research, including references to studies and published papers, as well as ongoing studies and reports. Some were based on opinions.

Throughout the call for evidence, we heard that standardising tobacco packaging in the UK and internationally has been effective in reducing the appeal of tobacco products. We also heard that pack inserts have been effective in Canada at supporting existing smokers to make quit attempts.

We were told that the prevalence of the products in scope is relatively low but varies between different demographic groups. We also heard concerns - from respondents with links to the tobacco industry in particular - about the costs and complexity of implementing standardised packaging and pack inserts.

We have set out further details of our analysis in 6 themes:

• evidence and examples of standardised packaging
• evidence and examples of pack inserts
• evidence on prevalence and use of the products
• evidence on health harms of the products
• evidence on how products are sold
• evidence of the impact of standardised packaging on businesses

Analysis of call for evidence themes

Evidence and examples of standardised packaging                                                                                    

Many responses provided evidence suggesting that standardised packaging for tobacco products has had a positive impact. We received several published articles, information on international regulations and post implementation reviews. This included:

• multiple references to a Cochrane review (McNeill and others, 2017)
• systematic reviews (Noar and others, 2016; Drovandi and others, 2019; Moodie and others, 2011)

The evidence highlighted the potential beneficial effect standardised packaging can have on:

• reducing smoking rates
• lowering the appeal of products
• increasing the awareness of health harms
• increasing the use of smoking cessation services

Evidence also suggested that existing standardised packaging measures for cigarettes and hand rolling tobacco have not led to a growth of the illicit market and that there is strong public support for these measures.

Some respondents with links to the tobacco industry provided evidence, including tobacco industry funded reports, suggesting that standardised packaging for cigarettes and hand rolling tobacco has not directly reduced smoking rates. These respondents said that extensions of the measures are not required. Evidence also included published articles, data and information highlighting that the products in scope account for a large share of the illicit tobacco market. Some of these sources were funded and published by the tobacco industry.

We also received views without evidence from some respondents. These included views on which products should be in scope and that standardised packaging would simplify enforcement.  

Respondents with links to the tobacco industry shared views on how standardised packaging would impact small businesses, be challenging to implement for specific tobacco products and may lead to an increase in the illicit market.

Evidence and examples on pack inserts

We received evidence from respondents highlighting the potential effectiveness of pack inserts for cigarettes and hand rolling tobacco. This included several published articles that suggest Canada’s pack inserts policy has been effective in supporting smokers to make quit attempts (Thrasher and others, 2015; Thrasher and others, 2016). Respondents also provided data and published articles that show public support for introducing pack inserts for cigarettes and hand rolling tobacco, including support from current smokers.

Respondents with links to the tobacco industry provided the government’s draft impact assessment for introducing pack inserts in the UK, published in 2023. The assessment only estimated the health impact for cigarettes and hand rolling tobacco due to limited evidence on the prevalence of other tobacco products at the time.

We also received views without evidence from some respondents. This included respondents with links to the tobacco industry who said that introducing pack inserts would increase packaging costs and impact small businesses. Some respondents with links to the tobacco industry also questioned the health impact of pack inserts.  

Evidence on prevalence and use of the products

We received data from multiple sources on the prevalence and use of tobacco products across different population groups. This included data for adults, young people and current and recent former smokers.

We received limited published evidence on the prevalence of herbal smoking products, nasal tobacco (for example, snuff) and other tobacco products (for example, blunts).

Responses provided multiple published data sources that identified demographic trends around the use of the products in scope. This included higher rates of chewing and waterpipe (for example, shisha) tobacco use among ethnic minorities. We received evidence that use is particularly high among people of South Asian ethnicity and those of other or mixed ethnicity.

Evidence from the responses also highlighted that waterpipe use is higher among young adults than older adults, and that young adults are more likely than older adults to have tried heated tobacco products. The evidence received also suggested an increase in the use of cigarillos, cigars and smokeless tobacco among 16 to 19 year olds in England in recent years.

Respondents with links to the tobacco industry in particular highlighted that the products in scope account for a small percentage of the overall market. They also said that cigar use is very low among under 25s in the UK.

Evidence on health harms 

We received a wide range of evidence from published articles that highlighted the health harms of products in scope compared to people who had never smoked. This included:  

• increased risk of mortality associated with smoking cigars and pipe tobacco
• greater cardiovascular risks associated with cigarillos, cigars and waterpipe tobacco (for example, shisha)
• increased cancer risks associated with cigars and waterpipe, nasal (for example, snuff), chewing and pipe tobacco
• low birth weight and other perinatal risks associated with waterpipe tobacco
• dental diseases associated with cigars and chewing, waterpipe and nasal tobacco

For heated tobacco, we received evidence of the potential health harms from published articles and reports. This included a Cochrane review, which found insufficient evidence of any difference in risk of adverse or serious adverse events between people who use cigarettes and those who use heated tobacco in the short term (Tattan-Birch and others, 2022). The review did find moderate-certainty evidence that heated tobacco users have lower exposure to toxicants than cigarette smokers. However, it also noted that most of the evidence for heated tobacco products was funded by the tobacco industry and had a risk of bias.

Separately, we received evidence from respondents with links to the tobacco industry comparing the health harms of heated tobacco with cigarettes, which suggested that heated tobacco was less harmful.

For the health harms of herbal smoking products and cigarette papers, we received published articles showing that both these products emit toxicants and that herbal smoking products emit carcinogens. We received no evidence on the health harms of other tobacco products, such as blunts.

Evidence on how products are sold 

We received a variety of responses on how the products in scope were sold. The main themes included:  

• brand names, colours and graphics used, and how this affected the appeal of products and how harmful people thought the products were
• packaging materials, such as wood, cardboard and plastic
• format of packaging, such as boxes, tins and pouches
• type of opening, such as sliding, removable or attached tops
• box markings, including information on age, origin or authenticity for cigars
• pack sizes, including the weight or number of units per pack and specific measurements of packaging
• flavours of products and preferences of flavours among some demographics of users
• existing packaging requirements, including pictorial and text health warnings, information about nicotine content, description of flavours and tobacco track and trace
• variety of products, including details of the number of unique products available on the market or held in a portfolio
• displays and advertisements for products
• types of shops where these products are bought

For cigarillos, we received published articles showing that menthol cigarillo sales have increased since the ban on flavoured cigarettes was introduced in the UK.

For cigars, some respondents with links to the tobacco industry highlighted specific needs, such as humidity requirements. They also said that some cigars are sold as investment items, with the packaging of these products being considered important to authentication and value.

Across many products, respondents provided evidence of products not complying with existing display and packaging requirements.

Evidence on the impact of standardised packaging on businesses  

We received evidence showing retailers in England felt that the introduction of standardised packaging for cigarettes and hand rolling tobacco had either no impact or a positive impact on their business (ASH, 2022). We also received evidence that the introduction of standardised packaging for cigarettes and hand rolling tobacco and the minimum excise tax was associated with a decline in sales and tobacco industry revenues (Hiscock and others, 2020).

Respondents with links to the tobacco industry said that standardised packaging could increase operational costs for manufacturers and retailers, particularly for specialist tobacconists. Some commented that standardised packaging could make it more complex for manufacturers to supply products to markets with different packaging requirements, which could affect product availability in the UK. Some also said businesses would need sufficient time to transition to any new requirements. However, we received limited published evidence to support these comments.

Next steps

We have considered the evidence provided and have set out the opportunities to regulate tobacco packaging in the Tobacco and vapes: packaging, appearance and display consultation, which has been published today. 

The Tobacco and Vapes Act 2026 includes a range of new regulation-making powers. The UK government and the devolved governments plan to make use of these new powers as soon as practical. This is part of a co-ordinated and comprehensive approach across the 4 nations to further tackle the harms associated with the use of tobacco, vaping and nicotine products.

References

ASH (Action on Smoking and Health). Regulation is not a dirty word: local retailers’ views of proposals for new tobacco laws. November 2022.

Drovandi A, Teague PA, Glass B and others. A systematic review of the perceptions of adolescents on graphic health warnings and plain packaging of cigarettes. Systematic Reviews 2019: volume 8, article 25.

Hiscock R, Augustin NH, Gilmore AB and Branston JR. Longitudinal evaluation of the impact of standardised packaging and minimum excise tax on tobacco sales and industry revenue in the UK. Tobacco Control 2021, volume 30, pages 515 to 522.

McNeill A, Gravely S, Hitchman SC, Bauld L, Hammond D and Hartmann-Boyce J Tobacco packaging design for reducing tobacco use. Cochrane Database of Systematic Reviews 2017: issue 4.

Moodie C, Stead M, Bauld L, McNeill A, Angus K, Hinds K, Kwan I, Thomas J, Hastings G and O’Mara-Eves A. Plain tobacco packaging: a systematic review. University of Sterling Research Report 2011.

Noar SM, Francis DB, Bridges C, Sontag JM, Ribisl KM and Brewer NT. The impact of strengthening cigarette pack warnings: systematic review of longitudinal observational studies. Social Science & Medicine 2016: volume 164, pages 118 to 129. 

Tattan-Birch H, Hartmann-Boyce J, Kock L, Simonavicius E, Brose L, Jackson S, Shahab L and Brown J. Heated tobacco products for smoking cessation and reducing smoking prevalence. Cochrane Database of Systematic Reviews 2022: issue 1.

Thrasher JF, Osman A, Abad-Vivero EN, Hammond D, Bansal-Travers M, Cummings KM, Hardin JW, Moodie C. The use of cigarette package inserts to supplement pictorial health warnings: an evaluation of the Canadian policy. Nicotine & Tobacco Research 2015: volume 17, issue 7, pages 870 to 875.

Thrasher JF, Swayampakala K, Cummings M,  Hammond D, Anshari D, Krugman DM and Hardin JW. Cigarette package inserts can promote efficacy beliefs and sustained smoking cessation attempts: a longitudinal assessment of an innovative policy in Canada. Preventive Medicine 2016: volume 88, pages 59 to 65.