‘Large tobacco warning more effective’

              

In India, the number of deaths caused by tobacco is expected to reach 1.5 million by 2020, up from 1.3 million in 2017. Measures taken to reduce tobacco consumption include the use of large pictorial warnings on tobacco packets. But the tobacco industry has been opposing a move to increase the size of such warnings, raising doubts about their efficacy.

Now, a study has shown that large health warnings on tobacco packets can be greatly effective in conveying tobacco’s ill-effects.

Key findings

* Researchers studied perceptions of both adolescents and adults on the effects of larger graphic health warnings covering 85 per cent of the packets against those covering 40 per cent of the area currently being used.

* The study included 2,121 participants. Of them, 62 per cent were urban residents and 72 per cent had never used tobacco. Half of the participants were from lower socioeconomic category and 46 per cent belonged to the middle socioeconomic category.

* The participants were shown four different types of packets - conventional packs, dummy packs with conventional background but with warnings in 40 per cent of the area, dummy packs with conventional background but new warnings in 85 per cent of the area and dummy packs with plain background and new warnings in 85 per cent of the area.

* It was found that packs with 85 per cent graphical warnings were perceived to be more effective in increasing noticeability of the warnings and conveying the intended health message. These warnings were also effective in preventing non-users from initiating tobacco use, and motivating users to quit.

* The study also highlighted the need for plain packaging instead of commercial packaging of tobacco, in line with the experience elsewhere.

Background

* Cigarette packets sold in India are required to carry graphical and textual health warnings. The warning must cover at least 85 per cent of the surface of the pack, of which 60 per cent must be pictorial and the remaining 25 per cent contains textual warnings in English, Hindi or any other Indian language.

* In 2003, India ratified the WHO’s Framework Convention on Tobacco Control, which includes a recommendation for large, clear health warnings on tobacco packs. However, there was a delay in implementing graphic warning labels.

* The Cigarette and Other Tobacco Products (Packaging and Labelling) Rules, 2008, requiring graphic health warnings came into force on May 31, 2008. Under the law, all tobacco products were required to display graphic pictures, such as diseased lungs, and the text in English, covering at least 40 per cent of the front of the pack, and retailers must display the cigarette packs in such a way that the pictures on pack are clearly visible.

* On October 15, 2014, Health Minister Harsh Vardhan announced that only 15 per cent of the surface of a pack of cigarettes could contain branding, and that the rest must be used for graphic and text health warnings. The health ministry amended the Cigarettes and Other Tobacco Products (Packaging and Labelling) Rules, 2008, to enforce the changes effective from April 1, 2015.

* However, the decision to increase the pictorial warnings on tobacco packets was put on hold following the recommendations of a parliamentary committee, which reportedly did not speak to health experts, but only spoke to tobacco lobby representatives. On April 5, 2016, the health ministry ordered government agencies to enforce this new rule.

* Following the intervention by the parliamentary committee, NGO Health of Millions filed a petition at the Supreme Court, which asked the government to stop the sale of loose cigarettes and publish bigger health warnings on tobacco packs.

Why are stricter laws necessary ?

* Nearly 1 million tobacco-related deaths take place in India every year, and in 2011, the total health expenditure burden from all diseases due to tobacco use amounted to more than Rs 1 lakh crore, which is 12 per cent more than the combined state and central government expenditure on health in 2011-12.

* The revenue earned through tobacco excise duty during the same period was a paltry 17 per cent of the health burden of tobacco.

* Also, 12 per cent of children in the 13-15 age group consume tobacco. Similarly, in the case of adults, the percentage is 35 per cent.