What do cigarette pack colors communicate to smokers in the U.S.?

BACKGROUND: New legislation in the U.S. prohibits tobacco companies from labeling cigarette packs with terms such as light, mild, or low after June 2010. However, experience from countries that have removed these descriptors suggests that different terms, colors, or numbers communicating the same messages may replace them.
PURPOSE: The main purpose of this study was to examine how cigarette pack colors are perceived by smokers to correspond to different descriptive terms.
METHODS: Newspaper advertisements and CraigsList.org postings directed interested current smokers to a survey website. Eligible participants were shown an array of six cigarette packages (altered to remove all descriptive terms) and asked to link package images with their corresponding descriptive terms. Participants were then asked to identify which pack in the array they would choose if they were concerned with health, tar, nicotine, image, and taste.
RESULTS: A total of 193 participants completed the survey from February to March 2008 (data were analyzed from May 2008 through November 2010). Participants were more accurate in matching descriptors to pack images for Marlboro brand cigarettes than for unfamiliar Peter Jackson brand (sold in Australia). Smokers overwhelmingly chose the "whitest" pack if they were concerned about health, tar, and nicotine.
CONCLUSIONS: Smokers in the U.S. associate brand descriptors with colors. Further, white packaging appears to most influence perceptions of safety. Removal of descriptor terms but not the associated colors will be insufficient in eliminating misperceptions about the risks from smoking communicated to smokers through packaging.