Countering smoke Larger pictorial warnings on cigarette packets can effectively communicate tobacco’s risks

CIGARETTE companies have implemented the new rule requiring 85% pictorial warning on tobacco products following the Supreme Court order refusing to stay the central government regulation which came into force on April 1.

Accepting the government’s stand that larger pictorial war nings on tobacco products are necessary to educate people and intended to discourage the consumption of tobacco, the apex court had asked the manufacturers to comply with the health ministry’s notification on increasing the size of the health warnings from 20% to 85% of the principal display area on packets.

The ministry’s order issued under Cigarettes and other Tobacco Products Act, 2003 came despite the Parliamentary committee on subordinate legislation recommendation that the war nings be brought down to 50% of the package surface area, as it said 85% was too harsh on the industry and failed to create any visible impact.

Though companies like ITC, Godfrey Philips India, Marlboro, and Four Square as well as Red and White had stopped production in April and approached various high courts, they had to fall in line pursuant to the apex court’s directions, even as it transferred the case back to the Karnataka High Court. Tobacco manufacturers argument was that the stipulation was likely to affect their right to carry on trade and business. Besides, they claimed that there was no evidence to suggest that large graphic health war nings reduce consumption.

The companies, which account for more than 98% of the country’s domestic sales of duty-paid cigarettes in India, put the estimated production revenue loss at over R350 crore per day for tobacco product manufacturers. In FY15, ITC had consolidated sales of R17,765.99 crore from cigarettes, which accounted for 46.22% of its net sales of R38,433.31 crore.

The World Health Organisation (WHO) has estimated that India has the second largest number of smokers in the world after China. According to the report on tobacco control in India, 8-9 lakh Indians die annually due to diseases attributable to tobacco-50% of cancer deaths, 40% of all health-related problems, and a majority of cardio-vascular and lung disorders in the country.

Looking at the rising figures, experts feel that such small steps like larger pictorial war nings on cigarette packets can be the most effective and powerful way to communicate health risks, especially to illiterate people, decrease tobacco consumption and increase motivation to quit. Many research studies have also demonstrated that "fear appeals" are effective in motivating health behaviour change like quitting.

According to Dr SP Byotra, senior physician, Sir Ganga Ram Hospital, nearly one million tobacco-related deaths take place in India every year. “India spends R30,000 crore annually to treat tobacco-related diseases. Such health warning on tobacco products being the most cost-effective tool may help users to visualise the nature of tobacco-related diseases and repel them. Tobacco awareness at the school level will help, too. It is the children who can force their parents to kick the butt,” says Byotra.

In 2003, India, together with 150 other countries, became a signatory to WHO’s Framework Convention on Tobacco Control at the 56th World Health Assembly, and is required to follow the WHO protocol for tobacco control activities. The use of pictorial warnings on tobacco product packets is one of the WHO’s declared six “M POWER” strategies designed to combat tobacco use in its member countries during 2008.

Despite having relatively lower tobaccousethanIndia,countrieslikeThailand (85%), Australia (75% front and 90% back), Uruguay (80%), Brunei (75%) and Nepal (90%) have large-sized warnings. The impact was found to be strongest on people with low education and low economic status.

After implementation of these new warnings, the percentage of smokers stating that the labels made them think about the health risks increased and as did the percentage of those saying the labels made them more likely to quit.

According to advocate Sumit Nagpal, the government from time to time has taken various measures but has failed to implement the rules properly. "The use of strong pictorial warnings can definitely warn the user against health hazards. And this will also ensure an individual the right to a healthy life. Our large illiterate population may get discouraged after seeing large pictorial war nings," he added.

Excise duty hike, proper enforcement of mandatory pictorial rule, ban on advertisements and surrogate promotion campaigns can also have much needed impact on tobacco consumption. indu.bhan@expressindia.com