WHO urges all governments to require pictorial warnings on tobacco packs

The World Health Organization (WHO) has urged governments to require that all tobacco packages include pictorial warnings to show the sickness and suffering caused by tobacco use.

WHO's call to action comes on the eve of World No Tobacco Day, 31 May. This year's campaign focuses on decreasing tobacco use by increasing public awareness of its dangers.

Studies reveal that even among people who believe tobacco is harmful, few understand its specific health risks. Despite this, health warnings on tobacco packages in most countries do not provide information to warn consumers of the risks.

A 2009 survey in China revealed that only 37% of smokers knew that smoking causes coronary heart disease and only 17% knew that it causes stroke. A 2003 survey in Syria found that only a small fraction of university students correctly identified cardiovascular disease as a hazard of cigarette or water pipe smoking. Research in other countries shows similar results.

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.

Effective health warnings, especially those that include pictures, have been proven to motivate users to quit and to reduce the appeal of tobacco for those who are not yet addicted. Studies carried out after the implementation of pictorial package warnings (warnings using pictures and text) in Brazil, Canada, Singapore and Thailand reveal remarkably consistent findings on the positive impact of the warnings.

"Health warnings on tobacco packages are a simple, cheap and effective strategy that can vastly reduce tobacco use and save lives," said WHO Assistant Director-General Dr Ala Alwan. "But they only work if they communicate the risk. Warnings that include images of the harm that tobacco causes are particularly effective at communicating risk and motivating behavioural changes, such as quitting or reducing tobacco consumption."

Yet only 10% of the people in the world live in countries that require warnings with pictures on tobacco packages.

"In order to survive, the tobacco industry needs to divert attention from the deadly effects of its products," said Dr Douglas Bettcher, Director of WHO's Tobacco Free Initiative. "It uses multi-million dollar promotional campaigns, including carefully crafted package designs, to ensnare new users and keep them from quitting."

"Health warnings on tobacco packages can be a powerful tool to illuminate the stark reality of tobacco use," Dr Bettcher added.