"Smoking is bad, it's not cool ... yet I'm still doing it": Cues for tobacco consumption in a 'dark' market

Tobacco companies have described Australia as a 'dark' market, because the country's ban on advertising and point-of-sale display and the requirement for plain packaging of tobacco limit their ability to promote or differentiate tobacco brands. But despite the absence of overt promotion of smoking or cigarettes, evidence shows that attempting quitters struggle to stop smoking in Australia, raising the question of what factors continue to prompt smoking, and whether further policy initiatives could help attempting quitters and smokers to quit, or smoke less. This study explores the stimuli that encourage smoking and failed quit attempts, using a novel method of real-time collection of in-depth data from smokers and attempting quitters. The results suggest that the denormalisation of smoking is resulting in lower levels of smoking, and in the absence of cues to smoke, many smokers and attempting quitters can abstain from smoking. Nevertheless, residual cues to smoke, including the mere sight of tobacco retail outlets and associated signage, prompt smoking related thoughts, complicate cessation attempts, and trigger relapse. The paper outlines implications for theory, explores policy that could limit the health and economic costs of smoking, and examines how support for attempting quitters might be improved. Crown Copyright (C) 2015 Published by Elsevier Inc. All rights reserved.