As a picture says thousand words, graphic health warnings are more effective than text warnings. The warning messages aid to changing consumers attitudes towards tobacco use as well as changing their behaviour. It captures attention, educate effectively about the health hazards of smoking and discourage the formation of this harmful habit. It is noted that Framework Convention on Tobacco Control (FCTC) is the first global treaty on public health focusing tobacco control. Bangladesh was the first signatory of the FCTC in 2003 and ratified in 2004. It is thus fundamental, legal and moral obligation of the government to obey this treaty.
According to Article 11 of FCTC, "Each unit packet and package of tobacco products and any outside packaging and labelling of such products must carry health warnings describing the harmful effects of tobacco use including other suitable messages. These warnings and messages: (i) shall be approved by the competent national authority, (ii) shall be rotating, (iii) shall be large, clear, visible and legible, (iv) should be 50 per cent or more but not less than 30 per cent of the principal display area, (v) may be in the form of or include pictures or pictograms."
Graphic health warning is the best way to provide information to smokers (and non-smokers too) regarding health risks of tobacco consumption. It is also no-cost initiative to discourage people from consuming tobacco. According to WHO, "A cigarette smoker sees the packages including an effective health warning at least 7,300 times per year". It is a cost-effective method to increase public awareness about the dangers of tobacco use. It is for enhancing public's awareness of the harmful effects of smoking and tobacco use. It provides more detailed health risk information, as well as quit-tips and messages encouraging smokers to quit. It will also make the family members of tobacco users aware. When any of the family members will see such health risks through graphic health warnings on tobacco packets, they will discourage their family members who use tobacco or smoke. We want to live healthy and save ourselves from passive smoking. We also need to care about the health of our nearest and dearest persons (family members and close friends).
However, the effectiveness of health warnings depends upon the size, positioning and design of pictures. Noticeable health warnings comprising text and pictures are better perceived and read more often by smokers than warnings that are purely text-based. Larger picture warnings are also more likely to retain their effectiveness over time and are particularly effective in communicating health effects to populations with low-literacy, children, young people and underprivileged population groups.
International Status report 2012 shows the top countries in terms of warning size as an average of the front and back are 82 per cent in Australia (75 per cent of front, 90 per cent of back), 80 per cent in Uruguay (80 per cent, 80 per cent), 80 per cent in Sri-Lanka (80 per cent, 80 per cent), 75 per cent in Brunei (75 per cent, 75 per cent), 75 per cent in Canada (75 per cent, 75 per cent), 65 per cent in Mauritius (60 per cent, 70 per cent), 65 per cent in Mexico (30 per cent,100 per cent), 60 per cent in Ecuador (60 per cent, 60 per cent), 60 per cent in New Zealand (30 per cent, 90 per cent) and 60 per cent in Cook Islands (30 per cent,90 per cent). In general, the warnings used in different countries try to
emphasize messages for the effective health warnings to discourage youths from starting to smoke and motivate adolescent smokers to quit.
Canada is the first country to implement graphic warning labels compliant with the guidelines of Article 11 of FCTC in 2001 whereas, Australia is the world's precedent to implement the plain packaging on December 1, 2012. Other countries are also preparing strong warning label policies in response to the new FCTC Guidelines. According to International Status report 2012, 63 countries have finalized the graphic health warning legislation.
Recently, Nepal has implemented a 75 per cent graphic health warning as compliant with FCTC Article 11 guidelines. It is one of the most significant triumphs in the struggle against tobacco use in Nepal and worldwide in 2014.
However, in Bangladesh even after more than a year of passing the law with a provision to introduce graphic health warnings on tobacco packets to deter smokers, the rules are yet to be finalized. It is being delayed due to the tobacco industry's lobbing with the government in order to hinder the implementation of the law.
Moreover, the civil society is working toward establishing a world free from the devastating health, social, economic and environmental consequences of tobacco and tobacco use. Cigarette label containing warning is one of several national level policies that have been introduced to address the economic and health burden of tobacco use.
According to a study conducted by the US smokers want to see more health information on cigarette packages. Data from International Tobacco Control Surveys of smokers from 10 countries in 2006 show that the percentage of smokers who want to see more information on cigarette packages is greater than the percentage of smokers who want to see less information even in countries where graphic warning labels had already been introduced.
The use of graphic health warning on all of tobacco packets, packages, cartoons is every important to create awareness about health hazards of tobacco use and smoking. Thus it is can be very effective to reduce tobacco use and contribute in the long term to reduce tobacco related mobility and mortality and hence to improve public health globally.
To compel the tobacco manufacturers to inscribe graphic health warnings on tobacco packets; first of all the Rules must be finalized under the amended Tobacco Control Law. It is our hope that the government will take necessary measures to pass Rules soon.r
Manjushree Maharjan is an FK Fellow working with Work for a Better Bangladesh (WBB) Trust from RECPHEC in Nepal. Aminul Islam Sujon is Executive Editor of Swamaswar, an anti tobacco newsletter published by Bangladesh Anti Tobacco Alliance-BATA