Large Tobacco Pack Warnings Save Lives

Media statement by Dr Henk Bekedam, WHO Representative to India

23 March 2016

The current debate on reducing size of pack warnings, especially on bidis and smokeless tobacco is worrisome, especially because large and prominent health warnings have shown to be a cost-effective means of increasing public awareness of the health effects of tobacco use and in reducing tobacco consumption.

Tobacco use is a major risk factor contributing to a number of chronic diseases, including cancer, lung diseases, and cardiovascular diseases; it seriously affects the human and fiscal health of the country. In India, nearly a million deaths occur annually due to tobacco and the economic burden attributable every year to tobacco-related diseases is a staggering INR 104 500 crores.

India implemented Article 11 of WHO Framework Convention on Tobacco Control (FCTC) a few years back, but is still not FCTC compliant for this provision as the tobacco pack warnings occupy only 40% of the principal display area only on one side of the pack i.e. 20% of the total display area of the pack.

India is ranked 136 of 198 countries according to the international status report on Cigarette Package Health Warnings, 2014 and countries ranked after 143 do not display pictorial health warnings at all.

Any reduction in size of pack warnings will be a great setback for public health in the Region, as neighboring countries, including Nepal (90%), Thailand (85%), Pakistan (85%), Sri Lanka (80%) and most recently Myanmar (75%) have overcome similar challenges and notified large pictorial warnings.

As per the Global Adult Tobacco Survey-India (GATS 2010) covering the age group 15 years and above, 71% of cigarette smokers noticed health warnings on cigarette packages and 38% thought of quitting because of the warning label; 62% of bidi smokers noticed health warnings on bidi package and 29% thought of quitting because of the warning label, and 63% of users of smokeless tobacco noticed health warnings on smokeless tobacco product package and 34% thought of quitting because of the warning label.

This demonstrates the key role of health warnings as a preventive and public health promotive measure.

Prominent pack warnings also assist in reducing illicit trade and improve tax administration because these products are easy to distinguish from those which do not conform.

On 15 October 2014, the government issued a notification making it mandatory for tobacco companies to display graphic health warning occupying 85% of the principal display area of all tobacco packs. The gazette notification amending Cigarettes and Other Tobacco Products (Packaging and Labelling) Rules, 2008, which was to come into effect from 1 April 2015, is now scheduled to come into force on 1 April 2016.

This implementation will uphold the proud announcement made by the country at Moscow in 2014, during the sixth session of the Conference of the Parties (COP6) to the WHO Framework Convention on Tobacco Control (FCTC).

Along with large graphic pack warning, tobacco taxation is a recognized cost-effective and evidence-based population level strategy to reduce tobacco use. Both these measures are easy to implement, with no cost to the government.

In India, the most commonly used tobacco products are smokeless tobacco and bidis. These forms of tobacco are poorly taxed and therefore remain available at very cheap prices, making them very affordable and accessible.

Tobacco taxation as a fiscal policy is a ‘win-win’ situation. It not only increases revenue generation, it also reduces the consumption of tobacco, especially for the young and poor.

Today, as India stands on the threshold of hosting the seventh session of the Conference of the Parties (COP7) in November 2016, implementation of the 85% pictorial health warnings on both sides of all tobacco packs and the development of a comprehensive tax policy for tobacco products will uphold India’s position as a global leader in health and save precious lives.