Health Warnings

Overview

Contrary to popular opinion, many smokers are not aware of the risks of tobacco use. They may know that tobacco “is bad for them,” but few realize the magnitude of risk relative to other behaviors (like eating junk food, for example), their likelihood of dying from a tobacco-caused disease (half of all smokers), or can name specific diseases, other than lung cancer, caused by smoking.

Experience in Brazil, Canada and other countries shows that strong health warnings on tobacco packages – particularly warnings with images – can be an important source of information for young smokers, and that warnings increase smokers’ knowledge of risk and their motivation to try to quit smoking.

Smokers’ knowledge of risks

Are Smokers Adequately Informed About the Health Risks of Smoking and Medicinal Nicotine? Cummings KM, Hyland A, Giovino GA, Hastrup J, Bauer J and Bansal MA

Tobacco risk perceptions and behavior: Implications for tobacco control K. Michael Cummings

“Bulletproof skeptics in life’s jungle”: which self-exempting beliefs about smoking most predict lack of progression towards quitting? Oakes W, Chapman S, Borland R, Balmford J and Trotter L

Legislation on image-based warnings

“A picture tells a thousand words.” So it seems with package warnings. A number of countries now require health warnings with images on tobacco packaging, starting with Canada in 2000 and Brazil in 2001. Research has found that strong, relevant image-based warnings inform smokers and motivate them to try to quit smoking. Click below for information on each country.

Australia
Brazil
Canada
European Union
Singapore
Thailand
Uruguay
Venezuela

Images on package Health Warnings

Visit the following links to see photos of warnings by country.

Australia
Brazil
Canada
European Union
Singapore
Thailand
Uruguay
Venezuela

Evidence on effectiveness of health warnings

Impact of health warnings messages Health Canada commissioned studies

Labeling research (pre-implementation of image warnings) Health Canada commissioned studies

Evaluation of new warnings on cigarette packages Canadian Cancer Society

Enhancing the effectiveness of tobacco package warning labels: a social psychological perspective E J Strahan, K White, G T Fong, L R Fabrigar, M P Zanna and R Cameron

Impact of the graphic Canadian warning labels on adult smoking behaviour D Hammond, G T Fong, P W McDonald, R Cameron and K S Brown

Response of Australian health groups to 2004 warning label proposals (excellent summary of the issues)

Tobacco industry responses

Cigarette Pack Labeling BAT PowerPoint presentation concluding that “current conventions and treaties afford little protection” against health warnings.

"Avoid health warnings on all tobacco products for just as long as we can": a history of Australian tobacco industry efforts to avoid, delay and dilute health warnings on cigarettes S Chapman and S M Carter

Myths and facts

Package messages are ineffective

The package messages in many countries are ineffective because they are so small and give unclear information. But in Canada and Brazil, where health messages on packages are large and use pictures, messages have motivated many smokers to try to quit smoking. Smokers say that the information is relevant and informs them about the effects of smoking on their own health and on the health of others who breathe their smoke involuntarily. These messages can reinforce other elements of a tobacco control program, such as smoke-free environments.

People here buy single cigarettes, they won’t even see packages
If the health messages are large enough and clear enough, people will see them when they are displayed for sale, when they are taken out of smokers’ pockets and purses, and when they are discarded. Package messages are one of the cheapest and widest-reaching forms of public education available.

Many people can’t read so package messages won’t work
This is a good reason to have pictures accompanying text messages. Pictures can graphically illustrate the health harms of smoking and secondhand smoke, and can be understood even without text.