Pictorial health warnings, a deterrent for smoking?

by Kurulu Koojana Kariyakarawana

After a long time all the 225 members of the State legislature of Sri Lanka had showed their consent on one cause amidst all their divisions and agendas. All raised their hands last February 19th in favour of the introduction of compulsory pictorial health warnings to be displayed on cigarette packets as a cost effective way of increasing the public awareness on the dangers of tobacco use.

The government enacted three regulations with the fullest support of the opposition. The regulations that come under the National Authority on Tobacco and Alcohol Act, No. 27 of 2006, were taken up for debate by the Health Minister Maithripala Sirisena in his opening remarks said that the government should have implemented these warning in 2008.

As a signatory to the Framework Convention on Tobacco Control (FCTC) of the World Health Organisation Sri Lanka is bound by its regulations to implement pictorial health warnings on cigarette packets. Sri Lanka being the first country of the South Asian region and the fourth country in the world to ratify the FCTC Act in 2003 was among 170 countries in the world that adopted the regulations to implement pictorial health warnings on cigarette packets in 2005. According to the FCTC regulations, as signatories all countries should adhere to the Article 11 of the convention to implement large, rotating health warnings on all tobacco product packaging and labelling. And that all parties to the Convention should implement such warnings within 12 months of signing to the convention.

Although this never happened in Sri Lanka, a fresh initiative was made in December 1, 2006 where the National Authority on Tobacco and Alcohol (NATA) was established. And the National Authority on Tobacco and Alcohol Act, No. 27 of 2006 was passed and a series of activities were banned. These included smocking in enclosed places, propaganda and publicity on tobacco sale and promotion, selling tobacco products to minors under the age of 21.

Normal lungs                                         Infected lungs

However there are a series of actions the NATA has recommended to control the tobacco issue including the ban on tobacco promotion and patronage, introduce and implement pictorial health warnings covering at least 30% of the front and back of a cigarette packet and if possible up to 50% and also to save the people from passive smocking by banning smocking in public and work places, to increase the tax on tobacco to reduce sales, to clearly display the country of origin and sale on the packet, public awareness program against smocking and etc.

Ceylon Tobacco Company last year filed a case in the Supreme Court to repeal the regulations made by the Ministry of Health. The CTC challenged the Tobacco Product (Labelling and Packaging) Regulations No. 01 of 2012 dated 8 August 2012 made by the Minister of Health under the National Authority on Tobacco and Alcohol Act in the Appeal Court in February this year. The Appellate Court refused to issue a stay order sought by the company and the CTC filed a case in the Supreme Court. The Supreme Court issued an interim order suspending implementation of the gazette notification requiring to display pictorial warnings on cigarette packets in September 2013.

However giving the verdict last Monday the Supreme Court ordered to implement pictorial warnings covering up to 50% to 60% of a packet of cigarette. This however failed to make the Minister of Health and the interested parties satisfied as they demanded the warning to be covering 80% of a packet.

Minister Sirisena expressing his displeasure told the media that the fight against the tobacco menace is not over yet and they will do their fullest to put an end to this. On the other hand the CTC argued that by letting a warning covering 80% of a packet would unfairly affect their brand name and other product details.

And the Supreme Court in its verdict stated that the 50% to 60% was granted not only considering the public awareness on dangers of tobacco use but not to destroy a government approved company like CTC.

Although the pictorial warning scenario is new to Sri Lanka that created much controversy amongst those who fight for it and those who fight against it, it is not entirely a new thing in the world. Many western countries and in Europe as well as in Asia that has a heavy sale of cigarettes have implemented these warnings several years ago. If tobacco companies would argue that displaying disturbing and harrowing images of cancer wounds and non communicable diseases on their product is a significant sales drop for them, it is questionable how hardcore smokers would take it as a real warning to their health as many in such state are aware of the consequences of excessive smoking.

It is questionable how serious these warnings will be accepted by hardcore smokers who may need an additional medical assistance to quit their addiction to nicotine. Unlike in the Sri Lankan scenario this is really questionable in countries where people do smoke not only for the pleasure of smoking but also as a tool to warm them up in adverse cold weather conditions.

But this situation could be significantly different from those who are new to the habit of smoking and especially the younger generation. It is not an arguable fact that how multinational tobacco companies use clever methods to lure the unsuspecting young generations to smoking by creating an entirely a sweet picture of it. Although this crowd is not a chief portion among the targetted customers of these companies, there is a high tendency for the youth to distract themselves from the dangerous habit of smoking merely because of these alarming images of warnings.

One may argue that if something is legally not banned then why put restrictions into it. If the governments are really concerned about their citizens why couldn't they simply ban smoking in a country. Irrespective of the practical difficulties to achieve this goal due to the sale of tobacco being one of the highest tax earning trades in a country and in a country where tax earning is a crucial factor for the sustainability of the economy and development, it is a different story to put a ban on it like that. But bringing such a lethal habit to a control is not something entirely impossible and perhaps as a positive initiative on the path towards a total ban in the future.