Key Facts About Graphic Pack Warnings and Tobacco Use in India

Graphic Pack Warnings

India is obliged to implement large graphic warnings
Under Article 11 of the World Health Organization’s Framework Convention on Tobacco Control (FCTC), parties are required to implement packaging and labelling that effectively communicates – to both current tobacco smokers and to non-smokers and youth – the health risks associated with tobacco use. India is a party to the FCTC.

The implementation of graphic pack warnings is one of the World Health Organization’s M-P-O-W-E-R (W=Warn) strategies to reduce tobacco consumption.
Large graphic warnings are effective
Large graphic warnings are so effective because the tobacco user easily sees the warning every time they reach for or look at the tobacco pack – so the message is repeated and reinforced numerous times, every day.

Research from around the globe has shown that graphic warnings are:

• more likely to be noticed than text-only warning labels
• more effective in communicating the actual health risks of tobacco use
• more likely to increase the tobacco user’s thoughts about the health risks of tobacco use
• more likely to increase the tobacco user’s motivation to quit
• more likely to increase quit attempts
• more likely to deter youth from initiating tobacco use
• more likely to deliver a protective effect against relapse in ex-smokers 1 year after quitting.
• Large graphic warnings are highly effective in communicating the health harms of tobacco, irrespective of the tobacco user’s level of literacy. In many countries, including India, a large number of tobacco users have only low levels of education.
• Graphic warnings transcend language barriers in countries like India, where different languages and dialects are used across a large national population.
• Graphic warnings are more effective in delivering information about the real harms of tobacco use in a powerful and immediate way.
• As the tobacco industry pays for the packaging of the products it sells, large graphic warnings constitute the most cost-effective tool for governments to educate smokers and non-smokers alike about the health risks of tobacco use.
• In many countries, more smokers report getting information about the health risks of smoking from warning labels than any other source except television.

The need for large graphic warnings in India:

• A study published in 2014 in the Journal of Public Health- based upon research in India and several other low and middle income countries – found that current small or text-only warnings on tobacco packs do not help children understand the real harms of tobacco.
• Critically, this study found that of all the countries surveyed, children in India exhibited the lowest levels of awareness of health warnings on tobacco packs.
• Nearly 77% of Indian children surveyed could not recall seeing warning labels on tobacco packs.
• 98.4% of Indian children expressed a weak or no understanding of current health warnings on tobacco packs.

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About tobacco use in India
According to The Tobacco Atlas, in India:

• nearly a quarter (23.2%) of adult males
• 3.2% of adult females
• 5.8% of boys and
• 2.4% of girls smoke tobacco (cigarettes, bidis etc).
• More than a quarter (25.9%) of adults use smokeless tobacco.
• In total, more than 2,542,000 children and more than 120,000,000 adults in India use tobacco each day.
• According to the Global Adult Tobacco Survey, 40% of Indians are exposed to secondhand smoke in the home
  • Over 30% of Indians are exposed to secondhand smoke in the workplace
  • Around 50% of Indians are exposed to secondhand smoke in restaurants.
• In tables for total cigarette consumption by country, India lies 7th in the world.
• Tobacco is the cause of 14.3% of male deaths and 4.7% of female deaths in India.
• Tobacco kills more than 981,100 Indian citizens every year.
• The government of India acknowledges that tobacco-related disease costs the Indian economy over 1.4

trillion rupees every year – just among adults aged between 35 and 69. The total cost across all age groups would be even higher.

• In 2004-2005, tobacco consumption impoverished roughly 15 million people in India.
• Based upon clinical cases in his hospital, Dr Pankaj Chaturvedi, cancer specialist at Mumbai’s Tata Memorial Hospital, estimates that 80-90% of preventable cancers of the neck, head and throat are tobacco-related.
• Smoking increases the risk of poor outcomes from TB infection. In India, TB is the leading cause of smoking-associated excess deaths. Among Indian men aged 30–69, 38% of TB deaths are attributed to smoking.
• Tobacco farming and tobacco use in India co-exist with levels of under-nourishment of 17%.
• More than 40% of current smokers in India say they want to quit and more than 30% have tried to quit in the previous 12 months.
• The tobacco industry in India subverted a ban on some smokeless tobacco products that were classified as food products by producing products that are not classified as food.

India has fallen behind on implementing large graphic warnings, but has been successful in implementing novel strategies like its “Film rule”, where public service announcements warning of the dangers of tobacco use must be screened alongside films and TV shows that depict tobacco use.

• * Tobacco Atlas: TobaccoAtlas.org
• ** According to the Tobacco Atlas (TobaccoAtlas.org), the top 6 global tobacco company profits were $US44.1 Billion in 2013. This equals 2.741.706.556 lakh Indian rupee per year or 86.939 rupee per second.

Articles, News and more
Op-ed, Indian Express:
April 2, 2015: A promise to Sunita Tomar
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News Release from World Lung Foundation:
April 2, 2015: Sunita Tomar’s Story Shows Why India Needs Large Graphic Warnings
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