MUMBAI: When it comes to pictorial warnings on tobacco packets, India ranks a low 123 among 198 countries surveyed on the warnings parameter. While experts agree that pictorial warnings on tobacco packets is a proven strategy that deters people from smoking or chewing tobacco, the ground reality is that less than 40% of the display area on cigarette and tobacco packets is covered by the warnings in India. This finding was part of the ‘Cigarette Package Health Warnings: International Status Report’, released at a recent WHO Framework Convention on Tobacco Control (FCTC) conference.

India ranks 123 among the countries surveyed on the size and fulfillment of requirements for picture- based warnings on packets. Under the FCTC, an international treaty signed and ratified by India, the countries are required to carry health warnings on all packages of tobacco products describing the harmful effects of tobacco use. The warnings “should be 50% or more of the principal display areas, but shall be no less than 30% of the display areas”, and include pictorial warnings. Dr Pankaj Chaturvedi, oncologist at Tata Memorial Hospital who has been working against cigarette and tobacco products, said pictorial warnings serve as a deterrent to a first-time user.

“The tobacco industry has exploited loopholes in the pictorial warning notifications to subvert the law. While smokeless tobacco packets have gory pictorial warnings of mouth cancer, the picture quality is so bad that they become meaningless. Moreover, the cigarette industry chooses the least graphic warning— photo of a lung—that has literally no impact on a user’s mind.”

International guidelines under the FCTC recommend that warnings should be as large as is achievable, should include a rotating series of graphic pictures and should be on both the front and back of packages. Examples of pictures that appear on packages include a diseased lung or mouth, a patient in a hospital bed and a child exposed to secondhand smoke. However, the written warnings may not help much in compelling smokers to quit, say doctors. “Nearly 20-25% of Indian children are users of tobacco and nearly one-third users in India are illiterate,” said Chaturvedi.

“They cannot read the warning printed in Hindi or English. Pictorial warnings work better for them,” he added. “Considering that Australia has passed a law that mandates plain packaging of cigarettes packs to discourage branding, we still have a long way to go to get the message across to a user,” said Surabhi Shastri of ‘Smokefree Mumbai’ campaign.