Insights into Editorial: Let larger pictorial warnings stay
17 March 2016
Summary:
Just few weeks before pictorial warnings covering 85% of the principal display area of the front and back sides of all tobacco products can become effective, a Parliamentary Committee on Subordinate Legislation report tabled in the Lok Sabha recently said that the requirement will be “too harsh” on the tobacco industry and will result in “flooding of illicit cigarettes”.
Background:
In October 2014, the Ministry of Health and Family Welfare had first proposed that 85% of a cigarette packet’s surface area on both the sides should carry health warnings, up from 40% on one side of the packet. It was opposed by the tobacco industry and put on hold after the parliamentary panel said it needed to analyse the impact on the industry.
What has the committee recommended?
- The 15-member committee has recommended that pictorial warnings be restricted to only 50% on both the sides of the cigarette packets.
- In the case of bidis, chewing tobacco and other tobacco products, the committee has recommended that the warning be restricted 50% of the display area and on only one side of the packet.
The committee’s recommendations are based on the following assumptions:
- In the case of bidis, there would be virtually no space left for printing the brand name and logo if 85% of area is earmarked for printing the warning. Besides, it is impossible to print the pictorial warning on both sides as the bidi packet has practically only a single round surface.
- Also, such pictorial warnings, besides causing significant rise in illicit tobacco products, would severely impact the domestic cigarette industry and affect the livelihood of thousands of tobacco farmers and workers.
- However, the committee has not stated the logic for restricting the warning to only one side in the case of chewing tobacco products.
Problems with the committee’s recommendations:
- Various studies indicate that due to larger graphic warnings, 58% of smokers in Canada and nearly 54% in Brazil and Thailand changed their opinion about the health consequences of smoking. However, the committee has failed to take note of this.
- The committee attempts to justify the reduction in pictorial warning size by arguing that tobacco consumption in India has increased and not declined after pictorial warnings were introduced in 2009. Tobacco companies too claim that there is no evidence whatsoever to suggest that large, graphic health warnings reduce consumption. However, there is no clear evidence in this regard.
- Also, the committee’s claim that pictorial warnings would encourage illicit trade is at best hollow. According to a 2015 paper in the journal Tobacco Control, a national cross-sectional survey undertaken in Australia after plain packaging was introduced found “no increase” in the use of illicit unbranded tobacco, contraband cigarettes or purchase from informal sellers. If plain packaging does not lead to increased illicit sales, there is no reason to believe that pictorial warnings would. Needless to say, sale of illicit tobacco products is more likely to be linked to cost of tobacco products than larger pictorial warnings.
- The Committee also claims that education and awareness campaigns are better than increasing the pictorial size. While a comprehensive approach that includes education and awareness generation should be adopted, there is no evidence to back the committee’s claim. California spent millions of dollars to attain the level of awareness that Canada achieved through pictorial warnings at little or no cost to the government.
Why stricter laws in this regard are necessary?
- Nearly one million tobacco-related deaths take place in India every year, and in 2011, the total health expenditure burden from all diseases due to tobacco use amounted to more than Rs.1,00,000 crore, which is 12% more than the combined State and Central government expenditure on health in 2011-12.
- The revenue earned through tobacco excise duty during the same period was a paltry 17% of the health burden of tobacco.
- Also, 12% of children in India in the 13-15 age group use tobacco. Similarly, in the case of adults in India, the percentage is 35%.
Why larger pictorial warnings are necessary?
Besides being unaware of all the risks associated with tobacco use, a vast majority of consumers in India of bidi and chewing tobacco are poor and less exposed to awareness campaigns.
- Hence, larger images on both sides of the packet are the most effective and powerful way to communicate health risks to this population. They also provoke a greater emotional response, decrease tobacco consumption and increase motivation to quit.
Comparison to other countries:
India is ranked 136 among 198 countries in terms of prominence of pictorial health warnings on tobacco packaging.
- At 30%, the only other country on the list with a smaller warning than India is Cayman Islands.
- Despite having relatively lower tobacco use than India, countries like Thailand, Australia, Uruguay, Brunei, Canada, and Nepal have large-sized warnings.
How to curb illicit trade?
- Curbing illicit sales of tobacco products, if they really exist, should be a high priority for the government and the companies; there are several well-proven methods that India can adopt to fight this menace.
- For instance, Brazil and California use a digital tax stamp using invisible ink to keep illicit trade under check, while the European Union uses barcodes and Malaysia uses a security mark with a visible and an invisible feature.
Conclusion:
Unlike other measures, excise duty hike and bigger, graphic pictorial warnings are easy to enforce and have the highest impact on tobacco consumption. Considering the huge public health benefits, it is imperative that the Health Ministry ignore the recommendations of the committee and enforce pictorial warnings that cover 85% of the principal display area on both sides of all tobacco products. Any dilution in the size of warning would entail a delay of several months and cost thousands of lives. The country can ill afford it.
