• Less than 2 in 5 get warning on tobacco packs

    Less than two out of five tobacco users understand the message conveyed by the health warning images on cigarette and beedi packets. Nearly one-fourth are barely aware that such a warning is there, said 89-year-old senior oncologist Dr V Shantha, who is campaigning relentlessly for bigger health warnings on tobacco packs. A recent survey conducted by Cancer Institute of 180 people from Tamil Nadu, Gujarat and Andhra Pradesh who used tobacco products at least 10 times a day for at least six years found that 78% of them noticed the warning. While 21.7% understood the text content, nearly 40% comprehended what was on the picture.

    Many perceived the image as that of a chest, heart, skull or liver. Half of those surveyed said they planned to quit tobacco use. But, here’s the catch: Among the 180 people surveyed, only one cited pictorial warning as the reason for quitting smoking.

    Dr Shantha, who is a recipient of the Padma Vibhushan, said the Centre’s decision to increase the size of the health warning from 40% of the front panel of the packs to 85% was an important public health measure that would bring down tobacco use and eventually curb tobacco-related cancers of mouth, tongue and lung.

    “I am ashamed that the government realised the importance of warnings so late. We have been giving them evidence for formulating such policies for decades. Now that they have said it is mandatory, it should not be withdrawn. I will consider it as a personal defeat in my battle against cancer if they do that,” she said in an interview to TOI.

    On April 1, the government mandated cigarette makers to cover 85% of the area of a cigarette pack with pictorial warnings, including text saying “smoking causes throat cancer.”

    The tobacco industry moved court, shut down production units and is said to have lobbied with the expert panel constituted by Parliament to reduce the warning size to 50%. The Centre refused to budge, and, on Tuesday, Dr Shantha said it was important for doctors to run a parallel campaign to ensure the government did not buckle under pressure. The stakes are too high now for the government to withdraw the rule mandating warning images to occupy 85% of the face of tobacco product packs, say anti-tobacco campaigners.

    The Union health ministry has ruled that all tobacco packs sold from April 1 should have bigger pictorial warnings and carry a cancer warning text. Tobacco companies like ITC said implementing this would be an elaborate process involving substantial cost. A month ago, the parliamentary committee’s expert panel suggested 50% pictorial warning. “The government itself held out that it would await the committee’s report, industry was led to believe the government would re-notify new health warnings after considering the committee’s recommendations,” an ITC release said. The case about new warning was still pending in court, it added.

    Tamil Nadu People’s Forum for Tobacco Control state convenor Cyril Alexander accused the company of looking for a way to escape the rules.

    Until now, health warning rules in the country had been extremely lenient compared to countries like Australia, Canada, Nepal and Mexico. The new rule, upping size of warnings to 85%, will be one of the most stringent along with Thailand.

    Since pictorial warnings on tobacco packs were introduced in 2009, studies, including National Family Health Survey , have shown a decline in tobacco users across the country. Among women, a decline is already being seen in oral cancer cases. “But we still have a long way to go,” said oncologist Dr V Shantha.

    Several organisations, including Canadian Cancer Society , have said effectiveness of the warning would increase with the size. “The idea is to give lesser space to the promotion of branding of tobacco products, and attract attention towards the warning. That’s key,” she said. 

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