Should disturbing images be placed on cigarette packs?

         According to the World Health Organization, up to one half of all smokers will die from a tobacco-related disease, and half of these will die prematurely. Cigarette packaging and their design are a valuable communication vehicle for cigarette brands and a vital form of advertising for tobacco companies. Many smokers are misled by designs on cigarette packages and are misinformed that a particular package may be “safer” (Wakefield et al., 2002 ). There is a serious need to consider regulation of the packaging of cigarettes.

            Smoking is a known risk factor for respiratory, cardiovascular, and malignant diseases. In addition, some studies have also shown a strong association between smoking and ocular diseases that may lead to blindness. (Ng et al., 2010). However, most people are unaware of this link in comparison to well-known conditions such as lung cancer an heart attacks.  A recent study in Britain involving teenagers showed that teenagers would stop smoking on developing early signs of blindness over signs of heart disease, lung cancer, and stroke (Moradi et al, 2007).

            Therefore, it is evident that individuals need to be further educated on the effects of smoking on health in order to encourage the cessation of smoking. In efforts to dissuade smoking, a number of countries such as Australia, Brazil, Canada, and Singapore have used graphic warning labels to inform the public about the hazards of smoking on health. In 2001, a study in Canada showed that graphic health warning labels were effective in discouraging smokers from smoking. The study showed that close to one-fifth of smokers decreased their cigarette consumption as a result of the labels (Hammond et al., 2004). In Singapore, 28 percent of smokers said they consumed fewer cigarettes as a result of the warning. (Ng et al., 2010)

According to the World Health Organization, there are many reasons that images on cigarette packages would be beneficial. First of all, health warnings on cigarette packages that include images are an influential and cost-effective outlet for communicating health risks. Cigarette companies take on virtually all of the cost. Images make health risks more noticeable, effectively communicate risk, and motivate behavioral change. In addition, images engage people on an emotional level, and deter original cigarette branding. Finally, images reduce discrepancies in health knowledge to those who are illiterate. Overall, other countries have successfully implemented pictorial messages on cigarette packages to further inform the public with no litigation from tobacco companies and an increase in smoking cessation. I think it is time we so the same.

Hammond D, Fong GT, McDonald PW, Brown KS, Cameron R. Graphic Canadian cigarette warning labels and adverse outcomes: evidence from Canadian smokers. Am J Public Health 2004; 94: 1442–1445.

Liefeld, J. P. The relative importance of the size, content and pictures on cigarette package warning message (Research prepared for Health Canada–Office of Tobacco Control), September 1999. Available on-line at http://www. hc-sc. gc. ca/hecs-sesc/tobacco/pdf/liefeld-eng. pdf.

Moradi, P., Thornton, J., Edwards, R., Harrison, R. A., Washington, S. J., & Kelly, S. P. (2007). Teenagers’ perceptions of blindness related to smoking: a novel message to a vulnerable group. British journal of ophthalmology, 91(5), 605-607.

Ng, D. H. L., Roxburgh, S. T. D., Sanjay, S., & Eong, K. A. (2010). Awareness of smoking risks and attitudes towards graphic health warning labels on cigarette packs: a cross-cultural study of two populations in Singapore and Scotland. Eye, 24(5), 864-868.

Slade, J. (1997). Cover essay: the pack as advertisement. Tobacco Control, 169-170.

Wakefield, M., Morley, C., Horan, J. K., & Cummings, K. M. (2002). The cigarette pack as image: new evidence from tobacco industry documents.Tobacco Control, 11(suppl 1), i73-i80.

West, R. (2004). Warnings on cigarettes' destroying brand value'. Daily Telegraph (online edition), 28.

World Health Organization (2011). WHO urges more countries to require large, graphic health warnings on tobacco packaging. Saudi Medical Journal, 32(11), 1215-1216.

World Health Organization (2009). Showing the Truth, Savings Lives: The Case for Pictorial Health Warnings.

Who Framework Conventions on Tobacco Control (2003). Geneva, World Health Organization.