Thank you for smoking: A brief history of tobacco warning labels
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As turnarounds go, this one must count among the quickest. Within six months of deciding to go for bigger warnings on cigarette packs, the Union health ministry has halted the process in its tracks, prompted by a parliamentary panel report that claimed there were no “Indian studies” that linked tobacco to cancer or other diseases.
In question: The Cigarettes and Other Tobacco Products (Packaging and Labelling) Rules. The 2008 law mandates 40% of the surface of cigarette packs to be covered in graphic and textual warnings about the dangers of cigarette smoking.
In October, the then health minister Harsh Vardhan wanted this to be raised to 85%, with 60% graphic images and 25% written warnings. His successor J.P. Nadda, on Tuesday cited a parliamentary panel report to defer implementation of the changes, a day before it they were to take effect on 1 April. The committee was chaired by Bharatiya Janata Party (BJP) member of parliament (MP) from Ahmednagar, Dilipkumar Gandhi.
This is eerily similar to how the US and the UK began carrying warning labels on cigarette packs. Iain Gately, the author of the 2007 book Tobacco: A Cultural History of How an Exotic Plant Seduced Civilization, writes, “The concept of warning labels in the air since 1957, when a bill had been introduced in the Senate requiring all cigarette packs to carry the label, ‘Warning: Prolonged use of this product may result in cancer, in lung, heart and circulatory ailments and in other diseases.’”
He adds, “This bill was killed by tobacco industry supporters presumably on the grounds of aesthetics. Cigarette packets were masterpieces of design, and should not be defaced by crude statements of fact. By the mid-sixties, the government had worked up the courage to insist its citizens should be reminded of the risks every time they smoked. The tobacco industry stonewalled, hankering back to the days when you listed health benefits on a pack of cigarettes.”
While the US was still debating the health effects of tobacco and smoking, in 1957, the then surgeon general Leroy Burney “declared it the official position of the US Public Health Service that evidence pointed to a causal relationship between smoking and lung cancer.”
After growing pressure from medical groups, the then President John F. Kennedy authorised the creation of the surgeon general’s advisory committee on smoking and health (in the early 60s), which met for over a year, analyzing over 7,000 scientific articles and papers, before announcing a link between smoking and cancer. The committee, in 1964, released a 387-page report called Smoking and Health. As Harry Shapiro, in his 2004 book Recreational Drugs: A directory writes, “In unequivocal terms, it concluded that “cigarette smoking is causally related to lung cancer in men.” It said that the data for women, “though less extensive, point in the same direction.” The report noted that the average smoker is nine to 10 times more likely to get lung cancer than the average non-smoker and cited specific carcinogens in cigarette smoke, including cadmium, DDT, and arsenic.”
On 11 January 1964, as Mary Meinking writes in her book, Cash Crop to Cash Cow: The History of Tobacco and Smoking in America (2014), “The surgeon general of the US Public Health Service announced that there was a link between smoking and lung cancer. Then, on 1 January, 1966, the Federal Cigarette Labelling and Advertising Act came into force. Cigarette manufacturers were forced to put a warning label on every pack of cigarettes. The warning read “Caution: Cigarette Smoking May be Harzardous to Your Health.” Amazingly, cigarette sales rose by over 7.8 billion in 1966.”
In the UK, the Royal College of Physicians appointed a committee to survey a link between smoking and health in 1962. The committee in its report titled Smoking and Health, “clearly indicted cigarette smoking as a cause of lung cancer and bronchitis and that it probably contributed to cardiovascular disease as well.” The report led to a ban on cigarette advertising on television in 1965 and six years later, in 1971, the first warning labels on cigarette packs appeared, with “WARNING by H.M. Government, SMOKING CAN DAMAGE YOUR HEALTH” written on the left side of the packets.
Back home in India, the Indira Gandhi-led government passed a legislation in 1975 called The Cigarettes (Regulations of Production, Supply and Distribution) Act, 1975, which made mandatory statutory health warnings on all tobacco products, including those of the chewable variety like gutkha and pan masala. The warning text, written in English and in small letters, said “STATUTORY WARNING: CIGARETTE SMOKING IS INJURIOUS TO HEALTH” and for chewable tobacco, it read, “TOBACCO IS INJURIOUS TO HEALTH,” written in both English and Hindi.
The warning label applied for both cigarettes and cigarette advertisements in India. The first suggestion of a pictoral warning came in 1995, when a parliamentary committee suggested the use of “strongly worded statutory rotating warnings made effective through the use of symbols and pictorial depiction.” While cigarettes were largely consumed by an urban population, other forms of tobacco were increasingly popular in India’s rural areas. The 1995 committee suggested that the warnings must also be printed in regional languages.
In 2003, the parliament passed ‘The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act’ (COTPA), which prohibited smoking in public places like restaurants and pubs. It also prohibited the advertising of tobacco and tobacco products. However, it allowed surrogate advertising, used commonly by chewable tobacco companies, where they disguise their gutkha product as pan masala. Importantly, it also mandated that cigarette packets were required to carry pictoral warnings of a “skull” or a “scorpion”, with the text “SMOKING KILLS” and “TOBACCO CAUSES MOUTH CANCER” in two languages—Hindi and English.
Five years later, on 31 May 2008, a new set of rules, which for the first time required graphic health warnings, came into effect. The Cigarette and Other Tobacco Products (Packaging and Labelling) Rules, 2008 mandated that all tobacco products —chewable or otherwise—“were required to display graphic pictures, such as pictures of diseased lungs, and the text SMOKING KILLS or TOBACCO KILLS in English.” It was also the first time that cigarette packs had to use a part of their surface (40%) to display the warning, and retailers had to display them “in such a way that the pictures on the pack are clearly visible.”