All You Need to Know About the New Pictorial Health Warning on the Tobacco Products in India (2018–2019).
In August 2018, the Government of India, and Ministry of Health and Family Welfare released the new set of Pictorial Health Warning designs with two variations. The first design will come into force for all the products produced or imported on or after the 1st September 2018 and the second design from the 1st of September 2019.
Each of the designs has a unique image and a different primary message on it. In the first design, it reads ‘Tobacco causes cancer’ while the second one has a more aggressive tone to the message, which reads ‘Tobacco causes painful death’. Interestingly the new design has an image of a woman in traditional attire for its first release in 2018. The second design is set to release in 2019 with an image of a man.
In addition to that, the new designs are accompanied by a text ‘Quit Today Call 1800–11–2356’ placed at the bottom of the image. Both smoke and smokeless form of tobacco products are said to have the common specified health warning.
The Government of India and Ministry of Health and Family Welfare instructs that any person engaged in production, supply, import or distribution of cigarettes or any tobacco products must guarantee that all the tobacco product packages must have the specified health warnings precisely as endorsed. Any violation of the above-mentioned provision is a punishable offense with imprisonment or fine as prescribed in Section 20 of the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply, and Distribution) Act, 2003.
Tobacco use is the foremost cause of premature mortality around the world. Considering the ill-effects of tobacco usage many countries around the world have come up with national level policies to reduce the sale and use of tobacco. Apart from that, the World Health Organisation’s (WHO) Framework Convention on Tobacco Control (FCTC), and Cigarette and Other Tobacco Products Act (COTPA), has proposed international guidelines for everyone.
After persistent efforts through policy amendments and judicial interventions by various organizations and individuals, we have seen a substantial improvement in the knowledge, attitude, and perception on the ill-effects of tobacco. Health warnings on tobacco products are found to be the most direct and prominent way to communicate and bring behavioral changes (Hammond, 2010). The FCTC (article 11) and COTPA (section 8-Packaging and Labelling) recommend Pictorial Health Warning as one of their strategies to reduce demands and supply of all tobacco products. Following the Supreme Court of India’s amendment in COTPA, all tobacco brands sold in India(effective from 3rd April 2016) had to increase the pictorial warning from 40% to 85%. In addition to that, a mandatory text message warning had to be printed on the package of all forms of tobacco products.
According to GATS 2 (Global Adult Tobacco Survey 2 (2016–2017)), 61.9 % people thought about quitting the use of tobacco after seeing the picture on the cigarette packets, whereas 53.8% for beedi packets. In the case of the smokeless form of tobacco 46.2% of people thought of quitting the use of tobacco after seeing the picture. From this finding itself, it is evident that health warning plays a significant role in motivating the tobacco users to quit their habit.
On the other hand, from the above graph, it is evident that people have noticed health warnings in the tobacco packets. Also, when comparing with the GATS 1 (2009–2010) there is a huge positive difference in all the three areas (cigarette, beedi and other smokeless forms of tobacco).
Recommendations
Despite efforts made by many tobacco producers to remove this mandatory warning message, it has seen a good adoption on all forms of tobacco products worldwide, especially in the low and middle-income countries. However, the poor awareness among small-scale retailers in many parts of countries India poses various challenges in yielding the best results of this initiative.
This could have been more effective if there were awareness programmes conducted for the retailers who sell tobacco products. Without it, the small-scale and street vendors might not even be aware of the seriousness of this initiative. Only if managed to create well-informed and law-abiding retailers who start refusing the products that come without the mandatory warning, it will put pressure even on the local tobacco producers.
Another scope for improvisation I see is to go bilingual in the warning text. I strongly feel the authorities must consider having regional languages along with a message in English for better penetration of the message into each nook and corner of this country. This would especially be effective for the locally produced tobacco products like Beedi. However, the uneven packaging of such products may give serious challenges to the current design to have an impact.
It would be great if the helpline number has a provision to identify the caller’s choice of language and help him/her accordingly. This may be a huge task for a country like India with so many regional languages, but not a tough problem that cannot be solved, especially considering the positive impact it may have.
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