Health Warnings

Health warnings on tobacco packaging, especially those that combine text and pictures, are one of the most cost-effective and powerful ways to increase public awareness of the serious health risks of tobacco use and reduce consumption. Tobacco has the unfortunate distinction of being the only legal consumer product that kills when used exactly as intended by the manufacturer. While current and potential tobacco users may comprehend that tobacco is harmful, studies show that few understand its specific health risks. Effective health warnings have been proven to motivate users to quit and to reduce the appeal of tobacco to people who are not yet addicted, particularly youth. 

Progress made, more action needed

Despite the considerable body of evidence showing that health warnings work, in 2014 only 20% of the world's population lived in countries that require pictorial warnings on tobacco packaging. This number has risen steadily since 2010, but the WHO European Region has the lowest rate for implementing large warnings and the lowest share of countries requiring pictorial warnings. As of the end of 2014, 20 countries within the Region have pictorial warnings. 

Picture-based warnings enjoy significant public support; more than half of European Union (EU) citizens recognized the effectiveness of such measures in a 2008 survey. The European Union's revised Tobacco Products Directive, which enters into force in 2016, permits Member States to introduce plain packaging and increase the size of health warnings to 65% on both front and back, as well as 50% on the sides of the pack. Pictorial warnings are also mandatory under the new directive. 

Recommendations for health warnings

Article 11 of the WHO Framework Convention on Tobacco Control (FCTC) requires that tobacco product packaging provide health warnings describing the harmful effects of tobacco use. The guidelines on implementation of this article recommend that health warning labels on tobacco products cover a minimum of 50% of the front of the pack.
They also recommend that:

• written warnings should be large, clear and legible;
• warnings should feature mandated descriptions of harmful health effects and specific illnesses caused by tobacco use;
• warnings should appear in all principal languages of the country;
• warnings should appear on individual packs, on all outside packaging and retail displays;
• warnings should be rotated;
• warnings should appear on all tobacco products, including smokeless; and
• warnings should include a picture.

Pictorial health warnings that include graphic, fear-arousing information have proven to be particularly effective. They detract from the overall attractiveness of tobacco packaging, to deter new users who are often most vulnerable to manipulation through branding and imagery.

To enhance and accelerate the implementation of Article 11, policy makers should advocate for pictorial warnings on all tobacco products and help develop laws that require such warnings. The citizens of the WHO European Region deserve to know the truth about tobacco consumption and the dangers of second-hand smoke, and clear health warnings help to effectively communicate the risks.