An order requiring tobacco companies to print graphic health warnings on cigarette packs is contrary to law, the Philippine Tobacco Institute (PTI) said on Thursday.

Complying with the health department’s administrative order 2010-13 will be a violation of Republic Act 9211 or the Tobacco Regulation Act (TRA) of 2003, the group said in a statement.

The law prohibits the printing of any other health warning on cigarette packs other than those specified by law, the group said.

Under Section 13 (g) of the law, “no other printed warnings, except the health warning and the message required (by the law) shall be placed on cigarette packages.”

“If AO 2010-13 is implemented, cigarette manufacturers, exporters, and importers will be violating the TRA, which has penal provisions that could land them in jail and be meted heavy fines,” said the group, which includes Philip Morris-Fortune Tobacco Corp., the Philippines’ largest cigarette firm.

As a result, the PTI called on Health Secretary Esperanza Cabral to withdraw the said order, saying it is “defective” and “deplorable.”

“Secretary Cabral has wrought much confusion in taxation and regulation in the last days of this administration… We call on Secretary Cabral to immediately withdraw her defective administrative order and not embarrass her president any further,” the PTI said in the statement.

The PTI is a group of local cigarette manufacturers which include the Philippines’ biggest tobacco firm, Lucio Tan’s Philip Morris-Fortune Tobacco Corporation, and other corporations like the Anglo-American Tobacco Corporation, La Suerte Cigar and Cigarette Manufacturing Inc., and Mighty Tobacco Corporation.

The FTI likewise accused Cabral of “arrogantly flaunting her powers” by issuing the order and by-passing Congress, which the group said should be the one issuing legislations governing these graphic warnings.

“Congress did not pass such a law, after long consultations with all stakeholders, so Secretary Cabral usurped legislative powers and issued her own diktat. This arrogant flaunting of the law and arrogation of powers not hers to exercise should be condemned by all law-abiding citizens of this country,” the group said.

Cabral issued last week an administrative order requiring the printing of graphic warnings on the bad effects of tobacco smoking on cigarette packs, saying it was in accordance with an international treaty ratified by the Philippines back in 2005.

The Philippines is one of the 168 signatories of the World Health Organization’s Framework Convention on Tobacco Control (FCTC), which requires parties to the convention to “implement large, rotating health warnings on all tobacco product packaging and labelling.”

At least 38 countries and territories — including neighboring countries Thailand and Singapore — have already implemented the printing of picture-based warnings of cigarette packs, while 27 other member-states of the European Union has also recommended its implementation.

Comply or find alternative industry, Cabral says

However, Cabral remained firm about implementing the administrative order this month, saying tobacco companies can easily alter product packaging since they provide similar packages to other countries.

“These tobacco manufacturers are the ones who print and export packages with graphic warnings to other Asian countries. They can very well comply with the order,” she said in a phone interview with GMANews.TV.

The health department has given tobacco companies enough time to change their current packages and even invited them to a dialogue before the order was released, she said.

“We invited them, but nobody came except for one person,” she said.

The health secretary also said her administrative order does not violate any law, since RA 9211 only covers textual warnings.

“We consulted our legal experts here, and they said the order is well within the law. What we want now are graphic warnings, not textual ones,” she said.

Cabral likewise said that she expected strong opposition from tobacco firms after she released the order, but withdrawing her directive is not an option.

“In other countries, this order has also been met with opposition. Tobacco companies kept threatening to sue. It really depends on the political will,” she said.

“Natatakot ako, pero trabaho ko ito. Kung matatakot ako at hindi na magtatrabaho, I might as well resign,” she added.

Cabral also advised tobacco manufacturers to reconsider their options, since the DOH is determined to put an end to smoking in the country, especially among the youth.

“To the tobacco companies, I think they should start thinking of an alternative industry because we won’t stop unless we put an end to smoking here in the country,” she said.
By ANDREO C. CALONZO, GMANews.TV

In spite of the tobacco industry’s untiring efforts to stall the process for incorporation of pictorial health warnings on cigarette packs and outers, and to somehow have the momentous decision reversed, the Ministry of Health has elevated Pakistan’s international profile by formally launching picture-based health warnings with effect from today (May 30).

The warnings, which were announced in May 2009 by the then minister for health, Mir Aijaz Hussain Jakhrani, will be launched by Minister for Health Makhdoom Shahabuddin at a ceremony arranged to observe World No Tobacco Day. Ours is the 21st country in the world to be implementing graphic health warnings.

Pakistan took a giant leap forward last year by announcing historic measures for tobacco control, the introduction of picture-based health warnings being one of them. Even though these warnings were initially planned for implementation with effect from January 2010 and were delayed several times under pressure from various quarters, notably the tobacco industry, their implementation in Pakistan is doubtlessly a huge achievement that deserves to be acknowledged and appreciated.

Picture-based warnings appear in more than a dozen countries. The number of countries implementing picture warnings has risen from one in 2005 to 23 in 2009. Some of the Eastern Mediterranean Region countries using picture warnings are Jordan (2005); Egypt (2008); Iran (2009) and Djibouti (2009).

The Country Office of the World Health Organisation (WHO) in Pakistan has been encouraging the government to adopt picture-based health warnings that meet the criteria for maximal effectiveness. The subject was first raised during a presentation made in 2008, and then at the first meeting of the Technical Advisory Group in the beginning of 2008. After that, there was no looking back as the need for picture-based warnings was highlighted at every forum, with trainings being arranged for TAG members and the Ministry of Health. The media too played a lead role in having these warnings implemented in Pakistan.

The WHO particularly approves of tobacco health warnings that contain both pictures as well as text and urges countries to have a rotated series of warnings appearing at the same time, rather than just one. Multiple warnings provide more information to the consumer, increase overall impact, and reduce the “wear-out” effect. The first picture-based warning to appear on cigarette packs in Pakistan shows the effects of tobacco use on a patient suffering from mouth cancer, and will be replaced with a new one after a year.

Picture-based health warnings are particularly significant for countries like Pakistan, which are beset with poor literacy rate and inadequacy of resources for public health education. Such warnings are the most cost-effective communication medium available to convince people to quit. At present, a majority of the country’s illiterate population cannot decipher text-based warnings, and as such, remains oblivious of the deleterious consequences of tobacco use. Moreover, it is interesting to note that while picture-based warnings are determined by the Ministry of Health, the cost of the intervention is borne by tobacco companies. Such warnings are synonymous to mini-billboards that work 24/7.

Coming to the size of the health warning, we have examples of countries like Australia, New Zealand and Cook Islands, where the average front-back size of the warning covers 60 per cent of the pack; followed by Belgium and Switzerland (56%), Finland and Kyrgyzstan (52%) and 18 other countries (50%). In Pakistan, these warnings will cover 40% of the front and back of cigarette packs (30% being pictorial and 10% textual).

The WHO Framework Convention on Tobacco Control (FCTC) recommends that these warnings should cover 50% or more of the principal display area but shall be no less than 30% of the principal display area. The key objectives governing the introduction of health warnings are to inform consumers of the harmful effects of tobacco and to reduce consumption.

Studies show that smokers are not aware of or underestimate the health effects of tobacco use. In 1999, before the introduction of picture-based warnings in Canada, only one-third of smokers could recall that heart attacks and emphysema are caused by smoking. In Cuba in 1999, 17% of doctors and 20% of nurses who smoked believed that smoking caused more benefits than harm. In the US in 1995, only 39% of heavy smokers believed they had a higher risk of heart attack and only 49% believed they had a higher risk of cancer.

Real-world evidence from Canada and Singapore substantiates the usefulness of picture-based warnings to influence its consumers to quit. In Canada, 58% of the smokers thought more about the health effects of smoking as a result of the warnings; 44% said the warnings had increased their motivation to quit; and 27% of the smokers smoked less inside of their home as a result of the warnings.

In Singapore, 71% of the smokers said they knew more about the health effects of smoking as a result of the warnings; 28% said they smoked fewer cigarettes as a result of the warnings; and 14% said they avoided smoking in front of children as a result of the warnings.

With picture-based warnings finally becoming a reality in Pakistan, it would be useful for the WHO to support, in due course of time, similar studies to measure the impact of these warnings on smokers and non-smokers alike in this country.

BOSTON – Massachusetts could become the first state to force retailers to display — at their registers — graphic ads that warn customers about the effects of smoking, reports the Boston Globe.

Images in the ads would feature “ominously darkened lungs, damaged brains, and diseased teeth could start appearing before the end of the year in more than 9,000 convenience stores, pharmacies and gas stations, if a proposal by the state Department of Public Health is approved as expected,” writes the newspaper.

Also, retailers who refuse to post the signs within 2 feet of tobacco displays and registers could face fines of $100 to $300.

The ads mirror a New York City campaign that began last December. Massachusetts would use $316,000 in federal stimulus money from the CDC, notes the newspaper, “which will allow the state to provide the materials to retailers without charge.”

Jon Hurst, president of the Retailers Association of Massachusetts, commented that most retailers “will respond coolly” to another mandate.

“Do you really have to have additional graphic signage and multiple layers of it at each cash register?’’ said Hurst, adding, “If you warn on everything, those warnings become essentially meaningless. They already have signage on alcohol, tobacco, lottery, they have signage on price accuracy.’’

Philip Morris commented that such graphic warnings, if established, should be under the authority of the federal government, which has expanded authority to the FDA for the manufacture, distribution and retail sales of tobacco products as part of the Family Smoking Prevention and Tobacco Control Act, notes the newspaper.

The Massachusetts Public Health Council is expected to vote on the graphic posters in August.

In July, Turkey banned smoking in public places, becoming just the 7th country throughout Europe to approve anti-smoking policy.
The legislation was highly opposed by both smokers and bar owners, and even led to one death, when a bar owner was killed after he had asked one of the customers to put out his cig.

However, Turkish authorities attempting to consolidate their regulatory authority over tobacco industry obliged local cigarette producers to place graphic and written health warnings on cigarette packs covering more than 60 percent of the area of packs. The ordinance has been expected to become valid on January 1, 2010. However, the local cigarette makers had no intention to give up and comply with the upcoming law.
Mahmud Kadaglu, Chairman of the National Health Committee has declared that major tobacco companies, Philip Morris International and British American Tobacco have agreed to submit a collective suit to the Council of State (the Supreme Court in Turkey) to reduce the obligatory size of the graphic health warnings.

The plaintiffs suggest that the obligation of placing that the requirement of putting graphic images on cigarette packs in an effort to lower smoking rates by showing the severe health complications related to smoking will hurt competitive landscape in the industry. The mandatory size of new warnings is at least 65 percent of the packs, according to the cigarette-makers, what would oblige them to remove the logos of their products from the packages as there would be no space for those logos. The plaintiffs also claim that the latest regulation violates their commercial free speech rights, established by World Trade Organization and ratified by Turkey.

The NHS Chairman said that have invited doctors from all spheres of medicine, to take part in the lawsuit as witnesses. He said that tobacco giants have required a delay in execution of the law as long as the case is pending in the Council of State, and added that the latest legislation is not an infringement of international trade laws, mentioning that they are confident that the Council of State will reject the law suit or rule in favor of National Health Committee.

Mahmud Kadaglu as well declared that the health warnings covering at least 65 percent of the packs do not violate WTO standards, according to which it is permitted to cover at least 50 percent of the packs area.
He said it is inadmissible that the plaintiffs are willing to bereave Turkey of its right to protect the health of its residents whereas other nations successfully implement such policies without any difficulties and obstacles from tobacco companies.
According to numerous studies, placing graphic warnings of health consequences of smoking is an effective strategy and helps reduce smoking rates by approximately 5 percent.
The first hearing regarding the lawsuit would be held next week in Istanbul.

ANKARA, – Turkey will add visual health warning messages to cigarette packages produced as of Jan. 1, 2010, the semi-official Anatolia news agency reported Sunday.

Chairman Mehmet Kucuk of the Turkish Tobacco and Alcohol Market Regulation Board (TAPDK) told the agency that cigarette packages produced before Dec. 31, 2009 which only have written warning signs can be sold till June 30, 2010.

There will be no cigarette packages without visual warning messages in Turkey as of Jan. 1, 2011, Kucuk said.

There will be 14 pictures, which will be chosen from 42 sample pictures in the European Union’s system, on tobacco product packages to draw people’s attention to the harm of cigarettes, the chairman was quoted of saying.

Visual warning on cigarette packages is used in countries including Britain, Belgium, Romania, Brazil, Thailand and Singapore, the agency said.

A smoking ban came into effect across Turkey on July 19, extending an earlier prohibition on smoking to all public indoor areas including cafes, bars and restaurants.

Under the new rule, it is also illegal to advertise and promote tobacco products or the names and brands of tobacco producers, while TV channels and radios have to air at least 90 minutes of programs on the harmful effects of tobacco products every month.

EL PASO, Texas — The written warning label printed on cigarette packages will be replaced with a much larger label that shows graphic images of smoking’s side effects.

The new regulations are part of the Family Smoking Prevention and Tobacco Control Act passed in June.

The law calls for new labels to cover at least half of the front and back of each package and to contain images.

Smoker Marco Kato, of west El Paso, is part of the 21 percent of Americans who smoke daily, according to the Centers for Disease Control and Prevention.

“I probably buy a pack every other day,” said Kato. “Sometimes more on the weekends.”

He said he never looks at the current warning label on cigarettes. The drastic change in labeling is supposed to change that.

“I think it’s a great idea,” said Natie Castillo, of west El Paso. “Maybe it will give an incentive for people to think about it before they light up and smoke.”

The new labels will be more in line with those produced in most foreign countries. Labels from Canada show graphic images of various forms of cancer and even death.

“I think that’s great,” said Tara Kahn, of west El Paso. “It’s a picture, you know. You’re not just reading the words, you’re actually putting the words and the picture together so you’re seeing the effects of it.”

But Kato said most smokers are aware of the dangers, and no warning, despite how graphic, will be able to shake the addiction.

“I don’t think the label would change my mind,” said Kato. “I think prices will probably change people’s minds.”

The FDA has up to two years to develop the new labels. Then tobacco companies have 18 months to start printing them on the packages.


Copyright September 6, 2009 by KFOXTV