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A Graphic Approach to Cigarette Warning Labels

The Institute for Global Tobacco Control’s redesigned image database assesses graphic cigarette warning labels, one pack at a time.

In recent decades, cigarette smoking has declined dramatically in developed countries, however, the situation is radically different in many developing countries. Nearly 80 percent of the world’s 1 billion smokers live in low- and middle-income nations, according to the WHO.

Some countries have embraced the use of disturbing graphic imagery—cancer-ravaged lungs, rotted teeth and facial deformities—on cigarette packaging as a prevention tool. Still, tobacco manufacturers find ways to skirt anti-tobacco label laws.

In an effort to thwart such strategies, the Institute for Global Tobacco Control (IGTC) at the Johns Hopkins Bloomberg School of Public Health—with funding from Bloomberg Philanthropies through the Bloomberg Initiative to Reduce Tobacco Use—established the Tobacco Pack Surveillance System (TPackSS) database. The goal is to track whether warning labels are being implemented as intended in 14 low- and middle-income countries that top the list for tobacco sales and use.

According to Carmen Washington, MPH, MSW, research program manager for IGTC, the database “specifically monitors tobacco packaging compliance with country health warning label requirements and marketing/branding on the packs.”

The watchdog database collects and reviews images of cigarette pack health warnings to help ensure full compliance with a country’s requirements and alignment with the WHO Framework Convention on Tobacco Control Article 11 Guidelines. Additionally, Washington says, TPackSS “can be used by governments to critique and improve their tobacco packaging requirements.”

In countries like India, Bangladesh, Vietnam and the Philippines, for example, how are manufacturers incorporating legal guidelines requiring labeling? In the Ukraine, are warning labels compliant with government standards for the size and placement of text? In Russia, does the wording on the box hint at “flavor appeal” (“rum & cherry,” for example) as a form of marketing? Tobacco labeling laws differ from country to country, and many manufacturers use cigarette packages themselves as promotional space in markets that limit traditional advertising of tobacco products.

The database can be filtered by country, brand, year of collection and use of misleading language. TPackSS also permits users to upload images of packs they find to help document what’s on the market globally. Washington reports that the database has received uploads from Guatemala, Bolivia, Jordan, Bosnia, Jamaica, Malawi and Myanmar to name a few.

IGTC researchers hope that the database can serve as one more public health tool to educate consumers and hold tobacco product manufacturers accountable.

View the database             Submit a pack


 - Lindsay Smith Rogers