No Ifs About The Butts, No Matter How Much You Puff

One of the most powerful and cost-effective mediums to educate consumers about the hazards of smoking is the pictorial health warning on the package of tobacco products itself. It has universal reach, and the cost of package warnings is paid for by the tobacco companies, not the government. It is empirically established from the experiences of other countries that strong pictorial health warnings on tobacco products are powerful communication tools that can take the message of the health hazards of tobacco to the masses, including the illiterate. Health warnings on tobacco product packages are critical to any effective tobacco control strategy, as they deter non starters and motivate consumers to quit. Read more

Article 11 of the WHO Framework Convention on Tobacco Control (WHO FCTC – the global tobacco treaty to which India is a signatory) obligates its parties to ensure that tobacco products packages carry appropriate health warnings describing their harmful effects. According to Dr Samlee Plianbangchang, WHO Regional Director for Southeast Asia, "Tobacco is the only legally available product that kills people, and 1.2 million people die from tobacco use in our region annually. An effective tobacco control strategy is, therefore, not just a programmatic necessity but also a moral imperative."

The Cigarette and Other Tobacco Products Act, 2003, also mandates pictorial warnings on all tobacco products in India, with annual rotation of pictures/ photographs used in these graphic warnings.

Alas! The death peddling lobby of tobacco/ cigarette manufacturers seems to have a stronger hold on the Indian government, than the right to health of its millions. After many initial delays, India finally put out pictorial warnings on tobacco products from May 31, 2009. These proved to be very mild and hence ineffective. The hazy images of lungs and a scorpion's picture on gutkha and cigarette packets were ludicrously funny, and not scary, to say the least. As per its commitment to the FCTC, and its own obligations to implement domestic laws, the government agreed to replace them, with scarier pictures of cancer stricken mouths, by 1st June 2010. To the dismay of the anti-tobacco activists and all health conscious people, this date was then shifted to 1st December 2010, and now to December 2011.

Once again our democratic government has buckled under the pressure tactics of the tobacco industry. According to a news published recently (click on the link to read the news), a RTI query, filed by Voluntary Health Association of India (VHAI), has revealed that the new pictorial warnings on tobacco products were deferred due to pressure from the tobacco industry, including ITC and the Pan Shop Owners Association, which comprises retailers of cigarettes, bidis, chewing tobacco and betel leaf. The government has unashamedly 'admitted' that the new pictorial warnings on tobacco packs have been deferred because of the 'pressure' exerted by the industry and other interested parties. The RTI revealed that the tobacco lobby had also approached the Union Health and Family Welfare Minister of Government of India, Shri Ghulam Nabi Azad to delay the implementation. Union Law Minister Shri Veerappa Moily, received a letter from Paan Shops Owners Association of India dated, March 25, 2010, which said, "Due to graphic tobacco warnings, our retailers have seen a decline in the business of our members. About 60 to 70 per cent of the business of these shopkeepers comes from tobacco products, but the impact has been felt beyond just these products as customers are not visiting these outlets. We sincerely hope you will give due consideration to the voice of aam aadmi, that is to defer the introduction of the new health warnings."

The Health Ministry also admits to have received anti-pictorial warning representations from tobacco giants like the ITC and Tobacco Institute of India. One of them, from ITC and dated March 5, 2010 said: 'Rotation of designs every year is not worthwhile as any changes in the graphic elements of the tobacco packs will require substantial redesign of the packs which in turn would necessitate procuring of new printing cylinders and ancillary equipments for a large number of packs.'

Tobacco majors argued that they have large unsold stocks and must be allowed to expend these before the warnings are changed. They threatened to maintain the current halt on fresh production - a move that can impact the labour intensive industry including cultivators.

So the Cabinet not only took a decision on Dec 7 to further defer the pictorial warnings by a year, but the Ministry of Health and Family Welfare, through a Gazette notification dated 20.12.2020, amended the Cigarettes and Other Tobacco Products (Packaging and Labelling ) Rules 2008. For Rule 5 the following has been substituted --“Rotation of Specified Health Warnings—The Specified Heath Warning on tobacco packs shall be rotated every two years from the date of notification of the rules or earlier, as the case may be, as specified by the Central Government.”

It would be worth mentioning here that while Indian tobacco products warn consumers with hazy images of lungs and scorpion, other nations clearly depict the devastating impact of tobacco on a smoker’s health through graphic pictorial warnings. A picture from Uruguay shows a baby surrounded by cigarette-smoke rings, warnings from Thailand (it has implemented 9 different pictorial warnings on 50% surface area of cigarette packs) show pictures of a mutilated and cancer-affected mouth.
While Bangladesh has six different types of text warnings covering 30 percent surface area of all smoking tobacco products, Maldives has mandated five different types of textual warnings covering 30 percent surface of the cigarette package.

Even our next door neighbour Pakistan has introduced gory pictorial warnings on all tobacco packs from August 30 in a bid to deter consumers from smoking or chewing tobacco. It has made it mandatory for 40% of all tobacco packs — on both sides — to carry the image of a rotting mouth suffering from cancer along with a health warning.

On the contrary, India, where 2,500 people die daily due to use of tobacco, has put off the introduction of strong and gory pictorial warnings till December 2011. But there is a ray of hope from the judiciary, if not from the executive. Even as the government backed down under pressure, the Supreme Court recently banned plastic packaging for tobacco products. In a reference to the fight against cancer, the Apex Court said that unlike the government, it could not remain a mute spectator to the public health menace and asked the government to implement the order by March 2011, even if it "brings the entire tobacco industry to a standstill."

We can only hope (and fight) for better sense to prevail upon the rulers of our country, so that they do not barter the lives of millions for financial gains of a miniscule, yet powerful segment of society.

Shobha Shukla - CNS
(The author is the Editor of Citizen News Service (CNS) and also serves as the Director of CNS Diabetes Media Initiative (CNS-DMI).She is a J2J Fellow of National Press Foundation (NPF) USA. She has worked earlier with State Planning Institute, UP.  Email:, website:  

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