Warning Labels of cigarette packages; Are they EFFECTIVE ?

Addition  of pictorial warnings to the cigarette packages to warn about the dangers of tobacco and its health risks is being appreciated and implemented by 105 countries. (By 2017).


Number of countries which require picture warnings in cigarette packages

  • These 105 countries cover 58% of the world’s population.
  • Canada is the first country to require 50% size of warning on packages (In 2001).
  • Nepal is the country with the largest picture warning requirement in the world that should cover 90% of its package in both front and rear sides.
  • 94 countries need to have at least 50% of the package.
  • Most of the European Union countries require 65% of warnings.

Both cigarette manufacturing companies and smoking control bodies have found out that the cigarette package as a vehicle which can be used to promote their ideas from hand to hand. Therefore, if the governments are encouraged to propose and implement sufficient laws and orders required to allocate space on cigarette packages for compulsory health warnings, it turns out to be an effective way to communicate the health issues.

List of top countries with average size of picture warnings:

Place Country Average Size Front Back
1 Nepal 90% 90% 90%
1 Vanuatu 90% 90% 90% (in 2017)
3 India 85% 85% 85%
3 Thailand 85% 85% 85%
5 Australia 82.5% 75% 90%
6 Sri Lanka 80% 80% 80%

(CCS report, 2016)

This is a highly cost-effective way of communicating the risk of smoking and to address this issue by providing useful, impactful and motivational guide to quit the habit of smoking. Picture-based warnings deliver a strong message than a warning made only using text. Text warnings have been used in early days but it’s effectiveness depends on the literacy level of the consumer and the low noticeable nature of it has proven it to be less effective. In contrast, the effectiveness of picture warnings does not depend on the literacy level. They are noticeable, easy to memorize and more likely to trigger the need to quit smoking. According to FCTC, warnings must be in national language/s. Researchers have indicated that the novelty of the health risk communication plays a major part and periodically changing the pictures along with its texts would be more effective or otherwise the smokers will be resistant and less noticeable after seeing the same figures all the time.

Some of the examples of pictorial warnings are, diseased mouth or lung, a child born with diseases on a hospital bed, cancer patients body cuts etc. Many countries have included larger pictures as they are more effective. The negative feelings of fear and disgust displayed by the pictures have caused a large impact.

A picture says a thousand words

Branding images, colors, logos were used by the companies to distract the health warnings by blending it with the final design of the package. The requirement of plain packaging avoids manufacturers using brand colors, designs and logos. The packages are needed to come in a definite format, color, font size, material etc. This would reduce their marketing strategies to enhance appeal of cigarettes and emphasizing the important warnings.


Before plain packaging      After plain packaging

         (Australian cigarette package – Front)

When the details and the type of pictures displayed are concerned, men and women smokers have responded regarding the effectiveness of the warnings as follows. Most of them have mentioned that these types of warnings would motivate them to stop smoking.

Few differences in this data is that more women have found that the picture warnings which included affected babies were effective while men showed an importance to brain damage which causes from stroke.

At present, majority of smokers accept the health risks of smoking, yet gaps remain of their estimations and understandings. Even in a country like Canada, who’s tobacco prevention is at its best, still a large portion of smokers underestimate the health risks. Therefore, persistence of the health warnings, rotating the types of pictures and texts, increasing the warning display size in both front and back, avoiding distractions to the warnings, directing the package manufacturers use a plain package color to emphasize the warnings, appreciation of countries which dedicate to the communication of health risks with proven results and enforce it by law, are important in the process of minimizing the damage done by smoking.



Constantine, I., Gregory, C., Kostas, K., Anthony, K. (2009) Adolescents perceived effectiveness of the proposed European graphic tobacco warning labels, European Journal of Public Health. 19(2), 212-217, DOI: 10.1093/eurpub/ckp015

Nelly, L., Pascal, S., Mirna, W., Aoun, B., Rony, Z., Eric, E., . . . Michèle, D. (2017) Motivation to quit smoking and acceptability of shocking warnings on cigarette packages in Lebanon, DOI: 10.2147/PPA.S122877

Mutti, S., Jessica, L., Prakash, G., Mangesh, P., Gauri, D., Nigar, N., . . . David, H. (2015) Perceived effectiveness of text and pictorial health warnings for smokeless tobacco packages in Navi Mumbai, India, and Dhaka, Bangladesh: findings from an experimental study, Tobacco Control, DOI: 10.1136/tobaccocontrol-2015-052315

Hammond, D., Fong, T., McNeill, A., Borland, R., Cummings, M. (2006) Effectiveness of cigarette warning labels in informing smokers about the risks of smoking: findings from the International Tobacco Control (ITC) Four Country Survey, Tobacco control, 15(3), 19-25, DOI: 10.1136/tc.2005.012294

Michelle, H., Linda, P., David, N., Paul, M., Julia, G., Pascale, W. (2006) Reactions of Young Adult Smokers to Warning Labels on Cigarette Packages, American Journal of Preventive Medicine, 30(6), 467-473, DOI: 10.1016/j.amepre.2006.01.018

World Health Organization: Media Center, Tobacco fact Sheet. Retrieved by http://www.who.int/mediacentre/factsheets/fs339/en/


Picture Credits

The Tobacco Atlas http://www.tobaccoatlas.org/



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