Graphic health warnings

Background

Towards the end of June (25th, 2004) the Commonwealth made an announcement about graphic warnings on cigarette packets. Unfortunately, the position taken was consistent with the option preferred by the tobacco industry, that being: graphic warnings cover 30% of the front the pack and 90% of the back of the pack. ACOSH, along with other health and tobacco control groups, had previously prepared a comprehensive response to the “Draft Regulatory Impact Statement On Proposed Changes To The Trade Practises (Consumer Product Information Standards) (Tobacco) Regulations” (March 2004).

The current mandatory health warnings for tobacco products have been in force for over a decade. Over that time, they have not surprisingly, lost their impact on consumers. In addition, much more information is now available about the diseases and conditions caused by smoking than was available when the current warnings were introduced. It is important that such information is provided to consumers.

While a general awareness that smoking is harmful is high in Australia, research shows that smokers still lack an appropriate level of awareness of the range of diseases and conditions caused by smoking and of the magnitude of the risks they face.

Other jurisdictions now require large graphic health warnings on packaging, and their introduction in these jurisdictions has had positive effects. The Framework Convention on Tobacco Control (FCTC) acknowledges the desirability of introducing such warnings. Increasingly, there is a recognition that health-related information communicated in this way has greater impact than bland text-only warnings.

It is also important that in addition to health warnings, cessation-related information be included on packaging. Tobacco is, of course addictive, and more than 75% of smokers have made at least one attempt to quit. Warning messages about the harms caused by tobacco are more likely to be effective if combined with messages emphasising that quitting is possible and beneficial and informing smokers of where they can get help.

Current “information” about tar, nicotine and carbon monoxide contents is inaccurate and misleading, and should be replaced with qualitative information about chemicals in tobacco that will be more accurate and more meaningful to smokers.

Research shows that the front of the pack is the most important site for communication of information. The front of the pack is noticed far more by smokers than the back of the pack. The less information that appears on the front of the pack, and the smaller the warnings that appear there, the less effective the measures will be.

We proposed the following major recommendations accordingly:

  1. That the regulations proposing new, graphic health warnings and qualitative information about the chemicals in products be adopted.
  2. That of the two options proposed, the option requiring 50% of the front and 50% of the back of the pack and the inclusion of the QUIT line on the front, is adopted. Rather than that requiring coverage of 30% of the front and 90% of the back, with QUIT line on the back. We would recommend a 50% front, 90% back option above each of these two proposals.
  3. That the new regulations come into effect no more than nine months after gazettal, i.e. all products sold after that date must bear the new warnings.
    That the manufacture of products with the old warnings cease three months after gazettal.
  4. That the new regulations be reviewed after three years of operation.
    In June 2004 after learning that the tobacco industry was lobbying for a 30% front, 90% back option the same organisations made a further submission stating:

The health warnings currently required to be printed on tobacco products, which were introduced nearly a decade ago, have lost their impact and the information they contain is not comprehensive or up-to-date. The current review of the Trade Practises (Consumer Product Information Standards) (Tobacco) Regulations represents an opportunity to update the warnings and to ensure that they effectively communicate about the harm caused by smoking to consumers.

All the available evidence shows that large, graphic warnings, appearing on the front of the pack is the most effective way of communicating information to consumers. Of the two options currently being considered, the 50% front and 50% back of the pack option will perform that function more effectively. Only the tobacco industry favours the 30% front and 90% back of the pack option. All organisations and health professionals and tobacco control advocates whose role it is to work towards the reduction of death, disease and social costs caused by smoking favour the 50% front, 50% back of the pack option, and that position is an evidence based one.

The only argument that has been mounted in favour of the 30% front, 90% back option is that the 50% front, 50% back option will affect the value of the tobacco industry’s trade marks. To the extent that this is framed as a legal argument it is entirely without foundation. To claim that the 50% front, 50% back option might affect the value of tobacco industry trade marks or it’s profits, would simply be a consequence of up-to-date information about the harms of smoking being communicated to consumers in an effective way. It would be a consequence of reasonable regulation, justified on both consumer protection and public health grounds, not a cause for legal complaint by the tobacco industry. In short, there is no policy justification of preferring the 30% front, 90% back option over the 50% front, 50% back option.

The new regulations should be implemented as soon as possible. It has been over four years since the current review was announced by the Hon. Dr Michael Wooldridge in February 2000. Further delays will only prolong the current situation – in which it has been acknowledged that needs to be reformed – and benefits the tobacco industry. The Revised Regulation Impact Statement proposes an 18 month lead-in period from the gazettal of the new regulations until the new warnings are required to be printed on packs (departing from the 12 months proposed in the Draft Regulation Impact Statement). This cannot be justified. In Canada, manufacturers of leading brands were able to meet a six-month timeline; in Brazil, nine months. In Singapore, no products bearing the warnings can be sold more than 12 months after the new regulations come into force. (The value of such a final sale date, which is not, at present, being proposed here, is that it protects against mass production in the lead up to the new printing requirements coming into effect being used by manufacturers to ensure that products with the old warnings remain on the market for as long as possible).

Tobacco industry complaints that 12 months is not sufficient time to upgrade printing facilities should be recognised for what they are – stalling tactics. No more than six months should be given before the new warnings must be printed on all packs, and, no products bearing the old warnings should be allowed to be sold more than 12 months from gazettal of the regulations.

There is no policy justification for persisting with the 18 month lead-in proposed in the Revised Regulation Impact Statement.

Prepared by the VicHealth Centre for Tobacco Control, The Cancer Council of Victoria. (granted permission to use information).