The Technical Advisory Group (TAG) on Tobacco Control in Pakistan has advised the Ministry of Health to issue by May 31, 2009, a notification that makes the printing of picture-based health warnings on cigarette packs and cartons mandatory at the manufacturer, importer and retailer levels with effect from January 1, 2010.
In their fourth meeting held here on Tuesday, TAG members unanimously recommended that “any packages on the market without the package warning and labeling requirements will be subject to be confiscated and forfeited.”
The meeting adopted a series of recommendations that not only have the potential to help reverse the tide of death and disability resulting from rising tobacco use, but also to build Pakistan’s image as a country that can do a lot more than merely bowing to the influence of the powerful tobacco industry.
Director General Implementation of the Framework Convention on Tobacco Control (FCTC) Shaheen Masud, WHO Representative Dr. Khalif Bile Mohamud, senior policy analyst, Canadian Cancer Society, Rob Cunningham, and Dr. Farrukh Qureshi from the Tobacco Free Initiative, Eastern Mediterranean Region, WHO, addressed the meeting.
The members advised the Ministry of Health that in preparing the May 2009 notification, the FCTC Article 11 guidelines adopted at Conference of Parties (COP3) meeting held in Durban, South Africa, in November 2008 should be followed to the maximum extent possible. These guidelines stipulate that health warnings be in the form of culturally appropriate pictures or pictograms; in full colour rather than black-and-white; and on both principal display areas (or on all main faces if there are more than two) of the tobacco products packaging.
TAG recommended that pictures be included as part of tobacco package warnings; that the size of the warnings be at least 50 to 60 percent of the top of the package front and back, with Urdu on the front and English on the back; and that the series of picture warnings should include images that are “shocking” in nature. It was agreed that the above recommendations would apply to all types of tobacco products, as well as the ‘outers’ or cartons of tobacco products.
There was consensus over the need for a series of warnings appearing at the same time, rather than a singular message, so that each time a tobacco consumer picks up a cigarette pack, they have a new health warning to read. Rob told the meeting that Canada has 16 different warnings while some European countries have 14 warnings appearing at the same time.
The TAG members also recommended that a descriptive statement of the harmful emissions in smoke be included on the side panel of cigarette packages; and that there be no requirement to include machine test numbers for tar, nicotine, carbon monoxide or other substances.
Talking to ‘The News’ on the sidelines of the two-day meeting, Rob said, “Picture health warnings are specifically beneficial for Pakistan due to its relatively high rate of illiteracy. A text warning is useless for someone who cannot read.”
Article 11 of the FCTC also favours picture-based warnings because they have the added benefit of potentially reaching people with low levels of literacy and those who cannot read the language in which the text of the health warning in written. Additionally, picture warnings may also disrupt the impact of brand imagery on packaging and decrease the overall effectiveness of the package.
Rob said, “The guidelines adopted by 163 countries at COP 3 are very persuasive about the importance of picture health warnings, for which there is rising worldwide momentum.” He said the tobacco industry is opposed to picture warnings because of the fear of reduced sales, which is precisely the health objective of the intervention.
Rob, who has been involved with package warnings for several years now, informed that 28 countries have already required picture warnings on cigarette packs and cartons, and 57 countries have warnings that are bigger than those in Pakistan. He referred to the introduction of picture-based warnings as an intervention “where the Ministry of Health determines the content and the tobacco industry pays the cost!” “What a wonderful thing for a country of 170 million people,” he remarked in excitement. He said, “If Kyrghzstan can have picture warnings in two languages, covering 52 percent of the front and back of the cigarette pack, Pakistan can do it too. If Djibouti, a small, poor country, can have picture health warnings covering 50 percent of the front and back packing, Pakistan can too.”
Rob was of the view that even though Pakistan has made some progress, it still falls behind the international trend. “For a developing country, where resources are scarce, package warnings reach the entire country every day without costing anything. These mini-billboards are always there; they work 24 hours a day. What a cost-effective way to reach every person - be they in the mountains or deserts. Pakistan must capitalise this tremendous public health education opportunity,” he emphasised, adding that a person who smokes 20 cigarettes a day, is exposed to the package 7,300 times a year.
Rob said the future lies in having a health warning on each cigarette stick, a measure which no country has taken so far, and which is particularly relevant for countries like Pakistan where individual sticks are available for sale to trap young people who cannot afford to buy a whole pack.
Earlier, Dr. Bile emphasised that failures in tobacco control do not signify failure of strategies, but of implementation. “We have a strong opponent that spends billions to lure new targets. These MNCs have on their payroll, senior policy-makers who are supposed to fight tobacco. The amount spent on promotion of tobacco versus that available for health promotion has a ratio of 1:100,” he said, suggesting that a certain chunk of the revenue to the tune of Rs35 billion generated through tobacco sales in Pakistan should be channelled in the direction of health education. “The WHO pursues the government of Pakistan to proceed towards rotational as well as graphical messages, as early as possible,” he stated.
Sharing the progress achieved by Pakistan so far, Shaheen Masud said that for the first time, health warning has been extended from packs to outers as well. The packs with new health warning are required to be printed and sent to market with effect from July 1, 2009. She informed that the Tobacco Control Cell has already ordered picture-based posters and stickers. The meeting will continue today (Wednesday).
In their fourth meeting held here on Tuesday, TAG members unanimously recommended that “any packages on the market without the package warning and labeling requirements will be subject to be confiscated and forfeited.”
The meeting adopted a series of recommendations that not only have the potential to help reverse the tide of death and disability resulting from rising tobacco use, but also to build Pakistan’s image as a country that can do a lot more than merely bowing to the influence of the powerful tobacco industry.
Director General Implementation of the Framework Convention on Tobacco Control (FCTC) Shaheen Masud, WHO Representative Dr. Khalif Bile Mohamud, senior policy analyst, Canadian Cancer Society, Rob Cunningham, and Dr. Farrukh Qureshi from the Tobacco Free Initiative, Eastern Mediterranean Region, WHO, addressed the meeting.
The members advised the Ministry of Health that in preparing the May 2009 notification, the FCTC Article 11 guidelines adopted at Conference of Parties (COP3) meeting held in Durban, South Africa, in November 2008 should be followed to the maximum extent possible. These guidelines stipulate that health warnings be in the form of culturally appropriate pictures or pictograms; in full colour rather than black-and-white; and on both principal display areas (or on all main faces if there are more than two) of the tobacco products packaging.
TAG recommended that pictures be included as part of tobacco package warnings; that the size of the warnings be at least 50 to 60 percent of the top of the package front and back, with Urdu on the front and English on the back; and that the series of picture warnings should include images that are “shocking” in nature. It was agreed that the above recommendations would apply to all types of tobacco products, as well as the ‘outers’ or cartons of tobacco products.
There was consensus over the need for a series of warnings appearing at the same time, rather than a singular message, so that each time a tobacco consumer picks up a cigarette pack, they have a new health warning to read. Rob told the meeting that Canada has 16 different warnings while some European countries have 14 warnings appearing at the same time.
The TAG members also recommended that a descriptive statement of the harmful emissions in smoke be included on the side panel of cigarette packages; and that there be no requirement to include machine test numbers for tar, nicotine, carbon monoxide or other substances.
Talking to ‘The News’ on the sidelines of the two-day meeting, Rob said, “Picture health warnings are specifically beneficial for Pakistan due to its relatively high rate of illiteracy. A text warning is useless for someone who cannot read.”
Article 11 of the FCTC also favours picture-based warnings because they have the added benefit of potentially reaching people with low levels of literacy and those who cannot read the language in which the text of the health warning in written. Additionally, picture warnings may also disrupt the impact of brand imagery on packaging and decrease the overall effectiveness of the package.
Rob said, “The guidelines adopted by 163 countries at COP 3 are very persuasive about the importance of picture health warnings, for which there is rising worldwide momentum.” He said the tobacco industry is opposed to picture warnings because of the fear of reduced sales, which is precisely the health objective of the intervention.
Rob, who has been involved with package warnings for several years now, informed that 28 countries have already required picture warnings on cigarette packs and cartons, and 57 countries have warnings that are bigger than those in Pakistan. He referred to the introduction of picture-based warnings as an intervention “where the Ministry of Health determines the content and the tobacco industry pays the cost!” “What a wonderful thing for a country of 170 million people,” he remarked in excitement. He said, “If Kyrghzstan can have picture warnings in two languages, covering 52 percent of the front and back of the cigarette pack, Pakistan can do it too. If Djibouti, a small, poor country, can have picture health warnings covering 50 percent of the front and back packing, Pakistan can too.”
Rob was of the view that even though Pakistan has made some progress, it still falls behind the international trend. “For a developing country, where resources are scarce, package warnings reach the entire country every day without costing anything. These mini-billboards are always there; they work 24 hours a day. What a cost-effective way to reach every person - be they in the mountains or deserts. Pakistan must capitalise this tremendous public health education opportunity,” he emphasised, adding that a person who smokes 20 cigarettes a day, is exposed to the package 7,300 times a year.
Rob said the future lies in having a health warning on each cigarette stick, a measure which no country has taken so far, and which is particularly relevant for countries like Pakistan where individual sticks are available for sale to trap young people who cannot afford to buy a whole pack.
Earlier, Dr. Bile emphasised that failures in tobacco control do not signify failure of strategies, but of implementation. “We have a strong opponent that spends billions to lure new targets. These MNCs have on their payroll, senior policy-makers who are supposed to fight tobacco. The amount spent on promotion of tobacco versus that available for health promotion has a ratio of 1:100,” he said, suggesting that a certain chunk of the revenue to the tune of Rs35 billion generated through tobacco sales in Pakistan should be channelled in the direction of health education. “The WHO pursues the government of Pakistan to proceed towards rotational as well as graphical messages, as early as possible,” he stated.
Sharing the progress achieved by Pakistan so far, Shaheen Masud said that for the first time, health warning has been extended from packs to outers as well. The packs with new health warning are required to be printed and sent to market with effect from July 1, 2009. She informed that the Tobacco Control Cell has already ordered picture-based posters and stickers. The meeting will continue today (Wednesday).
The $33 billion bill would raise federal taxes on selling cigarettes, cigars, rolling paper and other tobacco products to help fund the expansion. Cigarette taxes would rise from 39 cents per pack to $1.
Congressional Democrats previously pushed to extend the program to uninsured middle-class children, but efforts were vetoed by President Bush, who wanted the federal program geared toward the poor. President-elect Barack Obama is expected to sign the SCHIP expansion if it gains Senate approval.
House Democrats backed the expansion saying it will bring health insurance to more uninsured children.
The federal tobacco tax increase, however, faces criticism from economic conservatives.
“Tobacco tax increases over the years have resulted in less smoking and therefore a decline in tobacco tax revenue. Tying the expansion of a government program to a declining revenue source is the sort of backward thinking that makes taxpayers scratch their heads,” said Steve Voeller, president of the Arizona Free Enterprise Club.
A group of conservative economic groups wrote members of Congress earlier this month saying continued tobacco tax increases scapegoat smokers and hurt retailers and other small businesses by sending buyers online where they often can avoid such taxes.
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