Smoke and the mouth

Smoke and the mouth

The ministry of pubic health and family welfare has announced that starting 1 June, all cigarette and gutka packets must carry a pictorial health warning. According to the notification, the warning, a picture of a cancerous mouth, must cover at least 40% of the pack surface area.

In addition to this shock and awe strategy, the ministry has also notified that this image be changed every 12 months.

Both the nature of this image and the annual rotation are decisions that make theoretical sense.

Previously the ministry had notified a set of symbols in March 2008. But, according to a study undertaken by an NGO, the Voluntary Health Association of India, across seven states, these symbols were found to be ineffective.

This should have surprised no one. The old ruling asked for an image of a scorpion, signifying cancer, for smokeless products, and images of cancerous lungs, for products that were smoked—or at least that was the intention. The lungs looked nothing like lungs.

The new image of a diseased mouth is more direct and in line with a landmark February 2007 study that looked at the effectiveness of pictorial warnings. Published in the American Journal of Preventive Medicine, the paper titled “Text and Graphic Warnings on Cigarette Packages" surveyed almost 15,000 smokers in four countries that had pictorial warning regulations.

The study concluded that these warnings worked when they were large and direct. And, more significantly, if they were changed periodically. Smokers, it said, recalled warnings less if they remained unchanged for long periods.

The World Health Organization calls smoking “the leading preventable cause of death, tobacco kills more than five million people every year. It is the only legal consumer product that kills when used exactly as intended by the manufacturer."

This new notification ensures that the warning system is being implemented meaningfully. And it is timely.

According to one estimate, by 2013, one million Indians will die from smoking-related diseases annually. The annual costs of treating related diseases is estimated at $6.5 billion. A meaningful pictorial warning system could save money and lives.

Will the new pictorial warning curb smoking? Tell us at