How effective is pictorial warning on tobacco packets?

There were mixed results as global tobacco control parties met at a six-day negotiation at the seventh session of Conference of Parties (COP7) at New Delhi from November 07 to November 12, 2016.  The COP to the Framework Convention on Tobacco Control (FCTC) meets every two years. Known as COP7, the recent meeting brought together 180 parties to the FCTC, which represent nearly 90 per cent of the world's people.
The parties decided to develop a strategic framework for the FCTC that includes finding ways to attract more resources for the treaty and revising the crucial task of reviewing parties' progress in order to meet their technical assistance and resource needs.
An expert group had recommended creating an 'implementation review committee' to identify obstacles parties face while trying to put FCTC measures in place, and then to suggest ways to overcome such barriers. These obstacles include lack of political will, technical assistance and money, as well as interference from the tobacco industry.
FCTC measures have been identified by the World Health Organisation (WHO) as 'best buys' in fighting the killer group of diseases known as non-communicable diseases (NCDs), which include cancer, cardiovascular and lung diseases and diabetes.
NCDs cause nearly 2/3 of global deaths today, and it is estimated that they will cost the world economy US$30 trillion by 2031. In 2015, UN member-states highlighted the need for accelerated implementation of the Convention in the world's updated blueprint to development, the Sustainable Development Goals (SDGs).
At COP7, the UK announced about US$18 million in development funding to FCTC implementation, a sign that the international community is beginning to realise the treaty's significance in tackling NCDs.
COP7 also made progress on the issues of tobacco and human rights, and the health of tobacco farmers and agreed to change the name of parties' payments to the Convention to assessed contributions rather than voluntary assessed contributions, in a bid for more predictable funding.
However, parties failed to agree on measures to fight growing interference from the tobacco industry. The interference appeared to be on display in the proceedings of COP7 itself, which were repeatedly stalled by parties that attempted to water down previous COP decisions and even questioned the principles of the treaty itself.
Differences over how to address industry interference also prevented adoption of a strong decision on the FCTC's protocol on fighting illicit trade, or ITP, which is expected to come into force before the next COP session, scheduled for 2018, in Geneva.
Notably, a report on the outcomes of COP7 will be presented to the World Health Assembly (the governing body of the WHO) in May 2017 for the first time in FCTC history. This is to strengthen synergies between the two bodies.
The FCTC's measures include price and tax measures, large, graphic warnings on tobacco packages, 100 per cent smoke-free public spaces, a ban on tobacco marketing, support for smokers who want to quit and prevention of tobacco industry interference.
Tobacco control experts and policy analysts at a side session of the COP7 praised role of Bangladesh on implementing 50 per cent pictorial health warning in tobacco packets. The appreciation came after Bangladesh ranked 57th position among the 152 countries in an international status report-2016 of the Canadian Cancer Society (CCS).
The CCS launched its 5th international status report on cigarette package health warnings during a side session of COP7.
Bangladesh has improved its ranking on health warning packaging compliance on tobacco packets. The country's position was the 110th in the fourth report of the CCS published in 2014.
The CCS presented data of 205 countries in its report. Of the countries, some 152 implemented the health warning on tobacco packets.
Senior policy analyst of CCS Rob Cunningham said pictures are a very effective way to convey the health effects of smoking.
"Bangladesh should be praised for implementing 50 per cent pictorial health warning in tobacco packets," he said.
Text warning is not very effective in many countries for those people who do not speak or read the social language, he added.
"Tobacco industries in Bangladesh opposed the pictorial health warning. It means how effective it is!", he said.
Now, it is important for Bangladesh to place the pictorial health warning at the top of tobacco packs and make it larger to make it more effective, he added.
Package warnings are free. Bill board or poster campaigns involve cost, but it is not. Those packets with the warnings are seen by smokers all the time, he added.
Some of the illegal tobacco packets do not have health warnings which should be seized by the authority concerned, he said.  
Some 105 countries including Bangladesh have made mandatory printing of pictorial health warning on tobacco packets.
Matthew L. Myers, President of the Washington-based Campaign for Tobacco-Free Kids (CTFK), said: "Remarkable progress has been made around the world to ensure that the public knows the deadly truth about tobacco use - the world's leading cause of preventable death. More than half of the world's population now sees warnings on tobacco products that accurately portray the deadly consequences of tobacco use. Glossy images and appealing designs are being replaced by pictures of diseased lungs or even plain, drab packaging in more and more countries. The report shows outstanding progress - and sends a strong message to countries around the world that the time to take strong action to reduce tobacco's deadly toll is now."
Currently, tobacco companies in Bangladesh have to publish pictorial health warning covering 50 per cent area on both sides of tobacco packets.    
Nepal and Vanuatu jointly secured first position in the latest report of the CCS.  Both the countries implemented pictorial health warning in 90 per cent areas on both sides of tobacco packets.
India and Thailand jointly got third position by implementing mandatory pictorial health warning in 85 per cent area on both sides of tobacco packets.     
Although Bangladesh's position improved in global ranking, it is still lagging behind Nepal, India, Thailand and Sri Lanka.
On March 19, 2016, the government of Bangladesh made printing of coloured pictorial health warning mandatory in 50 per cent areas on the upper side of tobacco packets, packages, cartons or tin. But its implementation scenario is quite poor. In a study, it has been found nearly 75 per cent tobacco packets do not contain the health warnings.
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