European Commission will look at which pictures work best to help smokers quit

BMJ 2009; 338 doi: (Published 01 April 2009) Cite this as: BMJ 2009;338:b1351
  1. Ned Stafford
  1. 1Hamburg

    The European Commission is planning a new study aimed at developing better graphic images to warn of the damaging effects of tobacco, in a bid to encourage more European Union countries to put the pictures on cigarette packets.

    Haravgi-Nina Papadoulaki, spokeswoman for the EC’s commissioner for health and consumer protection, Philippe Brunet, said that, although the commission developed a library of pictorial health warnings in 2005, only three European Union member states have started putting the images on cigarette packets: the United Kingdom, Belgium, and Latvia.

    The commission has already asked researchers to submit proposals for the new study, which would include developing a new library of colour photographs, images, and text warnings about the negative consequences for health of tobacco consumption, said Ms Papadoulaki. The images and texts are intended to encourage smokers to quit and to deter young people from starting to smoke.

    To make the new combined warnings effective throughout Europe, they will be tested in all 27 member states among smokers, potential smokers, and former smokers, she said.

    “It is anticipated that a new library of pictorial warnings, tested in all member states and with various target groups, will encourage more governments to make use of the pictures,” said Ms Papadoulaki. “Latvia and France have taken a decision to require the use of pictorials, while further member states are considering introducing the warnings in the near future.”

    The best proposals for the study will be chosen and a contract signed by June, she said, and the results of the study are expected by early 2010. After the commission adopts the new library, the images and text warnings will be placed on a website and will be available free of charge to member states wanting to use them.

    She said that both the European parliament and “a number” of EU member states have called for the current library to be updated.

    Amanda Sandford, research manager of the UK’s Action on Smoking and Health, welcomed the commission’s plans for a new library, saying that her organisation had “argued for stronger warnings.” She said that people get used to images, even good ones, making it necessary to change them regularly to maintain effectiveness.

    Andreas Schoppa, an adviser to Germany’s federal drug commissioner, said that Germany is moving forward with plans to put pictorial health warnings on cigarette packets, with the final details being worked out between the ministry of health and the ministry of food, agriculture, and consumer protection. If the federal cabinet approves the plan, as expected, then it will be unveiled by the drug commissioner, Sabine Bätzing, on 31 May as part of the World Health Organization’s global “no tobacco” day.

    However, final decisions on exactly which images would be used and placement of the images on cigarette packets would not be made until after completion of the European Commission’s study, and pictorial warnings probably won’t appear in Germany before early 2011.


    Cite this as: BMJ 2009;338:b1351

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