Pictorial warnings on tobacco products in India

All tobacco products will display approved pictorial warnings and nicotine-tar levels from 30 November 2008, as per a notification issued by the Indian Ministry of Health and Family Welfare (dated 27 August 2008), in accordance with the Cigarettes and Other Tobacco Products (Prohibition of advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003. The implementation of pictorial warnings on tobacco products in India was initially planned for February 2007, but got deferred four times thereon.

Grim images of diseased lungs will appear on cigarette, bidi and gutkha packets, as per the notification, covering 40 per cent of the surface area of the tobacco packets, with the message: 'Tobacco kills/Smoking kills'.

The warnings were finally approved by a Group of Ministers (GoM), including the Union External Affairs Minister - Pranab Mukherjee, the Union Information and Broadcasting Minister - PR Dasmunsi, the Minister of State for Labour and Employment - Oscar Fernandes the Union Minister for Commerce and Industry –Kamal Nath, Union Minister for Culture and Urban Development –Jaipal Reddy and Union Health and Family Welfare Minister Anbumani Ramadoss.

Now, the tobacco industry has been given three months time to put up the pictorial warnings

The GoM formed in 2007 by the Government of India was tasked to review the pictorial warnings on tobacco products. This GoM decided earlier this year (February 2008) to go for mild pictorial warnings on tobacco products. This GoM declined to accept the pictorial warnings (skull and bones) on tobacco products that surveys conducted in India had shown to work towards tobacco control, rather picked up weaker warnings. The GOM in an earlier meeting this year headed by India's External Affairs Minister Mr Pranab Mukherjee had agreed for two mild images of a scorpion signal depicting cancer or an x-ray plate of a man suffering from lung cancer as pictorial warning to deter people from smoking.

Not only this is in compliance with the Cigarettes and other Tobacco Products Act, 2003, but also with the provisions of the global tobacco treaty On 5 February 2004, India had signed and ratified World's first corporate accountability and public health treaty – the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC). Article 11 of the FCTC states that warning messages should cover at least 50% of the principal display areas of the package (i.e. both the front and back), but at a minimum must cover at least 30% of the principal display areas. In India, these warnings will cover 40% of the principal display area of tobacco packets

Several nations have implemented strong health warning label requirements. Examples include:

- Canada, whose health minister recently proposed enlarging the labels from 30% of the package face to 60%;
- Thailand, which has added the message "SMOKING CAUSES IMPOTENCE" to its list of required warnings; and
- Australia, which was the first nation to require that "how to quit" information be printed on every pack.
- South Africa, Singapore and Poland also require strong warning labels.

These pictorial warnings provide smokers with helpful information on the health effects. Most smokers want this information, and certainly want their children to have this information too. The tobacco industry is continuing its decades-long strategy of trying to minimize the effectiveness of package warnings. The tobacco industry is no friend of smokers - and ironically it's true that 'the tobacco industry kills its best customers'. The Indian Council of Medical Research (ICMR) says tobacco use causes 10 lakh deaths (a million) in India every year.

Also package warnings on tobacco products are a good public health strategy because the cost of package warnings is paid for by tobacco companies, not government. Also this should not be looked upon as an isolated initiative rather has to be supported by comprehensive healthcare, legislations and education programmes to attain long-run public health gains. Hopefully this time, these pictorial warnings will get enforced from November 30.

(The author, writes extensively on development issues, is a World Health Organization (WHO)'s WNTD Awardee (2008) and can be reached at: bobbyramakant@yahoo.com)

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