Examining the effect of standardised packaging and limited flavour descriptors on appeal and harm perceptions of heated tobacco products

Introduction: Heated tobacco products (HTPs) are electronic devices that heat tobacco to produce an aerosol. In the UK,HTP packaging regulations are limited. The government has proposed powers to regulate HTP packaging, but specifics have not yet been outlined. This study investigated the impact of standardising HTP packaging and flavour names on 1) interest in trying and 2) harm perceptions relative to cigarettes. Methods: An online, between-subject design experiment surveyed 2,967 UK adults. Participants were randomised to view images of HTPs presented; 1)branded packaging (control), 2)standardised white packaging with typical flavour descriptors, 3) standardised white packaging with limited flavour descriptors. Participants indicated which they would be most interested in trying. Additionally, participants were asked about their harm perceptions. Analyses used logistic regression models. Results: Interest in trying was significantly greater for products in standardised packaging with limited flavour names compared to branded packaging (20.0%, AOR=0.48 [95%CI=0.33-0.71], p < .001). In all conditions, 30.2% perceived HTPs as harmful, but less harmful than cigarettes. There were no significant differences in HTP harm perceptions relative to cigarettes across packaging conditions (p>.05). Conclusions: Findings suggest that HTP packaging standardisation is unlikely to reduce appeal or make adults view HTPs as more harmful than cigarettes. This has important implications for HTP advertising policies.