Text-only health warnings on tobacco packages in China ineffective, but using large pictorial health warnings would significantly increase public awareness of dangers associated with smoking, says report by World Health Organization

Nevin Barich

BEIJING , April 9, 2014 (China Daily) – The health warnings on cigarettes packages in China have failed to raise public awareness of the dangers of smoking, a report by the World Health Organisation has found.

The report, released by the WHO and the International Tobacco Control Policy Evaluation Project on Tuesday, shows that the text-only health warnings on tobacco packages are ineffective, and using large, pictorial health warnings would significantly increase public awareness of the dangers associated with smoking.

China has the world's largest number of smokers, as 28 percent of the country's 1 billion adults are smokers. Meanwhile, more than 3,000 Chinese die every day - or more than 1 million each year - from smoking-related illnesses.

The report was devised based on three rounds of surveys with 5,000 adult smokers and 1,000 adult non-smokers in six cities. The surveys were conducted in 2006, 2007 to 2008 and 2009.

Bernhard Schwartlander, WHO representative in China, said that using large graphic warnings on cigarette packaging is a "very effective and incredibly cheap way" to raise public awareness of dangers of smoking, which is one of the top health hazards in China.

"Every smoker, whenever they take out a cigarette ... they look at the package. If there would be one (pictorial warning), it would remind them of the risks of smoking," he said.

However, even though China is a part of the WHO Framework Convention to Tobacco Control, the country has not fulfilled the Article 11 Guidelines in the convention, which requires that pictorial warnings must appear on at least 50 percent of the top and the back of cigarette packages.

Liang Xiaofeng, deputy director of the Chinese Center for Disease Control and Prevention, said the current packaging is "way too beautiful" and cigarettes are widely used as gifts in China.

Liang said China's cigarette packaging is far below international standards.

"Solely relying on the text, which is usually in gold, isn't an effective warning or form of education," he said.

China began using text warnings on cigarette packages in 2008. Liang said the CCDC, which also participated in the report, found that the warnings have not increased the willingness among smokers to quit.

However, Liang admits that it would be difficult to persuade the tobacco industry to use pictorial warnings on packaging.

"It is their bottom line and they will not give up easily," he said. "However, the economic benefits from the tobacco industry cannot offset the harmful effects of smoking."

Liang said China will likely introduce a smoking ban in public areas next year, but there's no guarantee that a mandatory requirement for pictorial warnings on cigarette packages will be included in the legislation.

Wang Ke'an, director of the ThinkTank Research Center for Health Development, said the government should toughen its stance against smoking and implement the pictorial warnings as soon as possible.

However, that could be a tough battle, Wang said. China National Tobacco Corp is the world's largest cigarette maker and the tobacco industry generates about 7 percent of the government's annual revenue, according to Xinhua News Agency.

"It is a simple choice: the public's health or the beautiful packaging. The evidence is compelling. If the government orders the implementation of pictorial warnings, it would be a display of the authority's support for a smoking ban," he said.

© 2014 dpa

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