WHO urges more countries to adopt large graphic health warnings on tobacco productsBMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d4237 (Published 07 July 2011) Cite this as: BMJ 2011;343:d4237
All rapid responses
Despite reports at WHO and Govt level about warnings of the health
hazards of tobacco, here in India the most frequent outlet is tobacco sold in packets. In a 1 kilometre stretch you can encounter more
than 5 (perhaps many more on busy streets) small roadside stalls selling sachets
of tobacco hanging alongside products such as bidi or cigarettes,
etc. On my 5km journey into work I see as many as
20 such spots. The ease of buying lures young kids, perhaps having fun initially, but who then develop a habit.
Also, in high income groups, cigarette smoking seems to be increasing in the name of "modernisation."
People ignore the health warnings, or do not read them, and continue to use
tobacco in one or other forms both in rural and urban areas. Easy
availability is one factor. Many Bollywood stars, role models for our youth, smoke a lot. Their fans follow suit. It is time to ban roadside tobacco outlets in
India. Availability should be restricted to a few outlets, and
our country's leaders should ban tobacco in any
Competing interests: No competing interests
Zarocostas reported WHO's pledge urging more countries to adopt large
graphic health warnings on tobacco products.(1) Indeed, the world map of
this powerful tool for tobacco control exhibits large and unjustified
Canada became the first country to implement health warnings on
cigarette packages in June 2001.(3) This was far before the Framework
Convention on Tobacco Control (FCTC) which came into force in 2005 and
specifically called in its comprehensive policy to implement health
warnings on tobacco packaging covering at least 30% (ideally 50% or more)
of the display areas.(4)
France was only the 39th country to enforce the FCTC recommendation
about pictures on packages in 2011 because the government allowed the
death industry an unbelievable two years for discussions plus a one year
delay to allow for the sales of the stock. Last but not least, the
required size is only 30% of the front and 40% of the back.
On March 1, 2010 Uruguay was the first country in the world to
require 80% of the package to be appropriated to health warnings. The
efficiency of large graphic health warnings to stop the tobacco deadly
pandemic is evidenced by the complaint filed by the giant Philip Morris
(market capitalization of $107 billion) with the World Bank's
International Centre for Settlement of Investment Disputes against the
little courageous Uruguay (Gross Domestic Product of $44 billion).(5)
Health warnings on cigarette pack are one of the powerful tools for
tobacco control. Their size may be the result of a complex balance between
MP's concerns about public health and the influence of the tobacco
1 Zarocostas J. WHO urges more countries to adopt large graphic
health warnings on tobacco products. BMJ 2011; 343:d4237
2 Tobacco Labelling Ressource centre. Available at
http://www.tobaccolabels.ca Accessed 11 July 2011.
3 White C. Canada plans stronger health warnings on cigarette packs.
4 Framework Convention on Tobacco Control. Available at
Accessed 11 July 2011.
5 Wilson D. Cigarette Giants in Global Fight on Tighter Rules. NewYork Times November 13, 2010. Available at http://www.nytimes.com/2010/11/14/business/global/14smoke.html. Accessed 11 July 2011
6 Watson R. MEPs back tougher health warnings on cigarette packets.
Competing interests: Dr Braillon, a senior tenured consultant in public health was sacked by the French Department of Health against the advice of the National Statutory Committee. Pr Dubois is being sued for libel by the French Tobacconists Union.(Abuse of libel laws and a sacking: The gagging of public health experts in France. Tobacco control blog 8 November 2010 http://blogs.bmj.com/tc/2010/11/08/)