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Author:Hassan Mir, University of Western
Ontario, Class of 2012
Introduction: With increasing restrictions on
cigarette advertising, the cigarette package has become a primary
marketing tool. Health warnings are associated with decreased
cigarette use while promotional labels minimize perceptions of the
harm caused by cigarettes, thus increasing initiation and reducing
quit rates. In many developing countries, smoking rates are already
high and increasing further. The Framework Convention on Tobacco
Control (FCTC) contains guidelines on labeling that have been
incorporated into domestic legislation in many countries. In this
study, we assess compliance with FCTC guidelines and domestic
legislation of cigarette packets from 12 countries at different
levels of economic development.
Methods: Researchers from 12 countries were
asked to send packs of at least 5 different types of commonly
consumed cigarettes between December 2007 and April 2008. The
countries from high income regions were - Australia, Germany,
Canada; high middle income - Chile, Brazil, Argentina, Malaysia,
Colombia, Iran; and low middle income - China, India, and Pakistan.
A total of 115 packets were inspected and all health warnings and
promotional labels were counted and evaluated for content,
location, and size using a structured data collection
Results: Health warnings were present on all
packages but in only 68% of boxes were they on the front or back
panels (defined collectively as the principal display area [PDA]),
the remainder being on the side panels. Only in Australia, Germany,
Canada, and Chile did health warnings meet or exceed the FCTC
recommended size of 30% or more of the packets PDA. Iran and India
had the largest discrepancies between the legislated requirements
(50% of PDA) and the observed label size - 2% and 4% respectively.
Cigarette packages from high income countries had an average of 3.0
warning labels per package compared to 1.4 warning labels per
package in low income countries. Promotional labels were
widespread, found on packets from all countries and more numerous
(although not necessarily larger) than health warning labels in all
countries except in Canada and Chile. The average number ranged
from 1.4 labels/package (Argentina) to 5.4 labels/package (Iran).
Deceptive terms such as "light" and "mild" were observed on 42% of
all packages examined.
Conclusion: Cigarette packages are widely used
to promote smoking and deceive smokers about health risks.
Furthermore, legislation on health warnings is poorly enforced and
FCTC guidelines are flaunted, particularly in lower income
countries. It is essential to monitor not only the existence of
legislation but also to evaluate its implementation. There is a
need to address promotional labeling, as its existence undermines
the effects of health warnings on cigarette packages. Mandatory
plain packaging offers a potential solution but will be opposed
strongly by the tobacco industry.
February 2012 Issue of IMpact