Worldwide call for larger pictorial health warnings
The FCTC Article 11 guidelines recognise that the effectiveness of health warnings increases with size - A larger size means that warnings are more visible, more important, and have more impact. A larger size allows for bigger and better pictures, a larger font size and/or additional information, including cessation information.
A larger size makes it more difficult for the branded promotional part of the package to distract the consumer’s attention away from the warning. That larger sizes are more effective is confirmed by the considered decisions of governments worldwide where the trend is very much to increase warning size.
All the Parties to the international tobacco control treaty of the World Health Organisation (WHO) - Framework Convention on Tobacco Control (FCTC) should have been implemented the treaty’s Article 11 - which is Pictorial Health Warnings on tobacco products within three years after the FCTC comes into force for that Party.
Sri Lanka ratified the treaty in 2003 and the FCTC came into force in 2005. Pictorial Health Warning regulation is one of the five key policies of WHO to reduce tobacco consumption - MPOWER.
Pictorial health warnings (PHW) on tobacco products constitute the most cost-effective tool for educating smokers and non smokers alike about the health risks of tobacco use. In many countries, more smokers report getting information about the health risks of smoking from warning labels than any other source. PHWs also provide high awareness to non-smokers, including children of the danger of tobacco smoking.
Theories in social and health psychology, supported by empirical studies, have demonstrated the superiority of using pictures and imagery over text-only messages in health communication. Article 11 also has a provision regarding emission information elsewhere on the package, with the Article 11 Guidelines providing that qualitative information should be used without tar and nicotine ISO yield numbers. Article 11 requires Parties to ensure that the industry’s use of the package is not “false, misleading, deceptive or likely to create an erroneous impression” - accordingly a growing number of countries have prohibited “light”, “mild” and other misleading descriptors.
Health warnings on packages of tobacco products are a highly cost-effective means of health communication. Package warnings reach every smoker (and consumers of other tobacco products) every day.
Guidelines
Warnings are always working - 24 hours per day, seven days per week. A pack a day smoker would take his or her pack out 20 times per day, 7,300 times per year. Warnings are also seen by those around the consumers, such as family, friends and co workers.
Consumers are entitled to be fully informed of the many health effects of tobacco products, and the package is the best way to do that. Studies show that consumers, including children, underestimate the health effects, in low, middle and high income countries. The tobacco industry highly opposes larger, picture warnings as a way to protect their sales volumes.
The FCTC Article 11 guidelines recognise that the effectiveness of health warnings increases with size - A larger size means that warnings are more visible, more important, and have more impact. A larger size allows for bigger and better pictures, a larger font size and/or additional information, including cessation information.
A larger size makes it more difficult for the branded promotional part of the package to distract the consumer’s attention away from the warning. That larger sizes are more effective is confirmed by the considered decisions of governments worldwide where the trend is very much to increase warning size.
A picture really does say a thousand words. Pictures are especially important for individuals who are illiterate or who have low literacy, an aspect especially important in many countries. Pictures are also important to immigrants, temporary workers as well as individuals from minority language groups who may not yet be able to read the national language.
Impact
The feasibility of implementing picture warnings has been demonstrated in a larger number countries/jurisdictions.To ensure better visibility and impact, picture warnings should be placed on both the front and back of the package (not just one of these), and should be placed at the top of the front/back, not the bottom, as provided in the Article 11 guidelines.
Australia which has the largest warnings in the world has also implemented plain packaging to prohibit tobacco company colours, logos, and design elements on the brand part of the package.
Plain packaging prohibits brand colours, logos and design elements on packages and requires that packages only come in a standard shape and format. Under plain packaging, health warnings should continue to appear, but the brand portion of the package has the same colour (e.g. brown) for all brands. The brand name is allowed on packages, but only in a standard location, colour (e.g. black), front style and size. Plain packaging would curb the industry’s use of the package as a promotional vehicle, would increase the effectiveness of package warnings, would curb package deception, and would decrease tobacco use.
Article 11 and the Article 13 guidelines under the FCTC recommend that Parties consider implementing plain packaging.
The deadly health consequences of tobacco consumption are well known the world over, and the tobacco industry resists every move by governments to protect their people from tobacco addiction. It understands the power of pictorial health warnings and uses all its clout globally to delay countries from implementing this tried and tested deterrent. The recent Cigarette Pack Health Warnings International Status Report, places Sri Lanka in 3rd place for the largest health warnings among 198 countries.
Sri Lanka warnings will cover 80 percent of the front and 80 percent of the back, which is far ahead of many developed countries, and reinforces the country’s commitment to the health and welfare of its people.
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