Health Warnings on Tobacco Products

Many countries require that tobacco product* packaging includes health warnings about the risks associated with tobacco use. Health warnings on tobacco product packages are effective in highlighting the perception of health risk , supporting the intention to quit tobacco use, discouraging the intention to begin tobacco use, and increasing cessation rates. Prominent displays of health warnings increase their effectiveness; larger warnings, with pictures, are more likely to be noticed, better communicate health risks, provoke greater emotional response, and further motivate tobacco users to quit. This report assesses the current status of tobacco packaging health warning requirements worldwide. Governments could further discourage tobacco use by requiring prominent health warnings on tobacco packaging.

Placing health warnings on tobacco product packages was one of the key evidence-based interventions included in the World Health Organization Framework Convention on Tobacco Control (WHO-FCTC), the first public health treaty negotiated under WHO auspices, which was adopted in 2005. Within 3 years, participating countries agreed to implement health warnings describing the harmful effects of all tobacco products. Article (Packaging and labeling of tobacco products) of WHO-FCTC requires government bodies such as ministries of health to approve and ensure the display of large, clear, visible, and legible warnings on at least 30%, and preferably 50% or more, of the principal display area of tobacco packages.

In early 2007, WHO’s Tobacco Free Initiative collected information about legally mandated use of tobacco health warnings through a questionnaire distributed to all 193 WHO member states and one territory. Data specific to health warnings were collected for seven criteria: 1) mandate of specific tobacco use health warnings; 2) inclusion of health warnings on tobacco packs and outside packaging; 3) use of large, clear, and visible health warnings; 4) rotation of health warnings; 5) use of the principal languages of the country; 6) inclusion of pictorial warnings; and 7) descriptions of specific harmful effects of tobacco use in health.

National data collectors were appointed by ministries of health and local WHO offices in each country to complete the questionnaire; regional data collectors, appointed for each of the six WHO regional offices, verified the accuracy and completeness of the data. The regional data collectors in turn submitted the data for further processing and analysis to the Tobacco Free Initiative. The results were validated by each of the member states and then published in 2008.

Data reported from 176 member states indicated that 77 (44%) did not require any warnings on cigarette packs, and 71 (40%) required warnings covering less than 30% of the principal display area. Among the member states, 23 (13%) had warnings that covered at least 30% of the main package display area and included one of the seven warning criteria. Five countries (Australia, Brazil, Canada, Thailand, and Uruguay) (3%) had warnings that covered 50% or more of the principal display areas and included all seven criteria. Among the 176 countries, 15 (9%) required pictorial warnings, and 66 (38%) countries had laws that ban the use of deceptive marketing terms (such as “light” and “mild”) that falsely convey that a particular product is less harmful than other tobacco products.

The percentage of member states that had no warnings or warnings that covered less than 30% of the principal package display area was high across all WHO regions: African Region (88%), American Region (74%), Eastern Mediterranean Region (82%), European Region (92%), South East Asia Region (82%), and the Western Pacific Region (71%). The level of implementation of health warnings was associated with a nation’s economic status.† Approximately 58% of low-income countries, 45% of middle-income countries, and 24% of high-income countries had not implemented any health warnings

Copyright © 2009 Cdc

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