While many countries have banned terms like light and low-tar from cigarette packs, other aspects of the products' packaging may also be misleading consumers, a new study suggests.

Studies have shown that long-used terms like light, mild and low- tar confuse many consumers into thinking that so-described cigarettes carry lower health risks. Dozens of countries have now banned tobacco companies from using the terms on cigarette packs.

But in the new study, Canadian researchers found that other packaging details -- words like smooth and silver, and even the color of the pack -- influence consumers' perceptions of a brand's health risks.

The findings suggest that current regulations are not going far enough to remove misleading elements from cigarette packs, the researchers report in the Journal of Public Health.

One remedy would be to require plain packaging, free of logos and other brand imagery, write David Hammond and Carla Parkinson of the University of Waterloo in Ontario.

Plain-packaging regulations came very close to being implemented in Canada in the early 1990s, and they are receiving serious consideration in several other countries at the moment, Hammond noted in an email correspondence to Reuters Health.

The tobacco industry is opposed to such measures, which is not surprising, Hammond noted, since packaging is a key marketing tool, particularly in countries where other forms of tobacco advertising are restricted.

And a cigarette pack's appearance does seem to influence many consumers' perceptions, Hammond and Parkinson found.

For their study, the researchers had 312 smokers and 291 non-smokers look at cigarette packs that had been specifically designed for the study. Participants viewed the packs in pairs, with the two products differing in one element of package design.

Overall, the study found, 80 percent of participants thought that the product labeled smooth carried fewer health risks than the one labeled regular. Similarly, when they viewed products labeled as either silver or full-flavored, 73 percent thought the silver

product was less hazardous.

Even numbers included as part of the brand-name influenced perceptions. Eighty-four percent of participants thought the product that included a 6 in the name was less risky than another product labeled with a 10.

Color also mattered. More than three-quarters of the men and women thought that the light-blue pack they viewed carried fewer risks than its dark-blue counterpart.

While the tobacco industry opposes the notion of plain packaging, Hammond said he is confident it will be a reality in the next five years -- likely with one country setting the precedent, and others quickly following suit.

Ultimately, Hammond said, the public may look back at today's cigarette packaging in the same way they now view the practice of having smoking sections on airplanes.

People will wonder how such a lethal product was ever allowed to be sold in packages with pictures of flowers and pretty coloring that appeal to young people and provide false reassurance to consumers about the risks of smoking, he explained.

SOURCE: Journal of Public Health, online July 27, 2009.

Canada