Pictorial warnings on cigarette packs – not a deterrent for smokers

Macabre images of faces disfigured by cancer caused by smoking put fear in the family members of the smokers though jury is still out on whether they have any effect on the smokers themselves or not.

Government of Pakistan, in 2010, decided to print pictorial health warnings on 40 per cent area of a cigarette pack in order to control the smoking rate by creating awareness about smoking related diseases.

Without conducting a scientific study of the effectiveness of health warnings, the government has now ordered to increase the size of health warnings up to 85 per cent.

While the World Health Organization (WHO) has made mandatory through article 11 of Framework Convention on Tobacco Control (FCTC) to assess the impact of packaging and labeling measures on the target populations, no such survey has so far been conducted globally.

Head of Psychiatry Department of Capital Development Hospital Dr Anwar-ul-Haq believes that such warnings could create awareness in new smokers to some extent but not among those who are already addicted.

“I have come across many patients who do not pay attention to these pictures. They believe that since their fathers or elder family members were also smokers and since they didn’t catch any disease they probably won’t fall victim to a tobacco related disease either,” Dr Anwar-ul-Haq said.

He said that pictures of mangled faces are a source of pain for the kids and family members of smokers as they think their fathers might catch the disease printed on the cigarette pack, but at the same time they feel helpless as they can’t stop it.

Noor-un-Nissa, 55, who is a chain smoker, said while talking about pictorial health warnings, “I am addicted to smoking because I enjoy it. Quitting on account of these pictures is out of the question. If suffering from cancer is my fate, then no one can stop it. My children got scared after watching these pictures and ask me to quit smoking, but I am helpless.”

She said that the pictures didn’t bother her but out of concern for her children she tore the pictures of ruined faces from the cigarette packs.

When contacted to learn about the effectiveness of pictorial health warnings and its impact on economy, Sakib Sherani, a leading economist said, “There is no doubt that these pictographic health warnings can create awareness effectively but government also has to control illegal tobacco brands that do not carry the warnings.”

Sherani said that illegal tobacco consumption was very high in Pakistan and that such brands did not adhere to the government’s guidelines. “So people who don’t like such pictures printed on legal brands can always turn to the illicit brands,” he said and added that if the government wanted to bring down tobacco consumption, it had to control illicit tobacco business which was attracting new smokers.

He said that government’s lack of action made legal brands more expensive and fueled the illicit tobacco business what ultimately hurt economy.

According to the latest research report ‘Asia-14 illicit indicator 2013’, the share of non-domestic Illicit consumption increased by 14.8 percent, from 3 billion cigarettes in 2012 to 3.4 billion cigarettes in 2013.

Government, following the footprints of India and Thailand, has decided to increase the size of pictorial health warnings. However, India put on hold the decision to implement 85% pictographic and text warnings on tobacco packs until its socioeconomic ramifications are evaluated.

Ministry of health hopes that new legislation will help to bring down the number of smokers in the country. Unfortunately, the countries Pakistan have not had raging success following this path. as according to a report by the International Tobacco Control Project (ITCP) India still has around 275 million tobacco users. ITCP India also conducted face to face interviews with 8,000 tobacco users and up to 94 percent of smokers in the survey said they had no plans to give up smoking even if pictorial health warnings get printed on 85 per cent of tobacco packing.