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Health Warning

Slovenia adopts plain packaging

Congratulations to SFP Coalition Partners No excuse Slovenia and Slovenian Coalition for Public Health, Environment and Tobacco Control for their tireless advocacy to support this legislation in the last year.

On 15 February the Slovenian Parliament adopted the draft law proposed by the government without a single vote against. Plain packaging is expected to enter into force in 2020.

Briefly, the new Slovenian Tobacco law includes:

– Plain packaging (65% coverage with health warnings and quitting information)
– Introduction of license for selling tobacco products,
– Total display and Tobacco advertising, promotion and sponsorship (TAPS) ban
– Prohibition of selling tobacco products with aromas and other additives
– Prohibition of smoking in cars with a minor present
– Prohibition of smoking indoors including E-cigarettes
– Mystery shopping/test purchasing by underage,
– Measures of prevention of illicit trade

Canadian Cancer Society Support on 85% HK Health Warnings

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Standardised Packaging and Tobacco Products Directive

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New warnings on cigarettes

Government has taken further steps to protect the public from the harmful effects of tobacco.

According to Minister of Health, John Boyce, producers, manufacturers and distributors of cigarettes will now have to ensure that included in the packaging and labels of cigarettes are graphic illustrations and strong wording to inform persons of the dangers of tobacco, and to discourage its use. Piloting the Health Services (Amendment) Bill in the Lower House yesterday morning, he said they will be given a reasonable timeframe to become compliant.

“Up until now cigarette packages in Barbados have been very liberal in terms of their designs and the packaging… I think there is a mention that the Minister of Health indicates that cigarette smoke is dangerous for your life. However, we’ve always felt we had to move beyond that and the internationally accepted battle is to move to a regime where the packaging is even more stark; and along with the messaging from the Minister of Health or the Chief Medical Officer in the country, we want to add to it some graphic illustration of the conditions which we could find ourselves having to deal with, if we continue to abuse or use cigarettes at all,” he told fellow Members of Parliament.

Those steps, he said are consistent with the guidelines set out in Article 11 of the Framework Convention on Tobacco Control. With that in mind, he explained that the package and label of any tobacco product should not contain any information that is false, misleading, defective or likely to give erroneous information about the characteristics, health effects or hazards of the tobacco product. He speaking particularly in relation to terms used on cigarettes packages such as “low tar”, “light” “mild” and “slim”.

“We do not recognise these are terms that change the form of the cigarette from dangerous to not dangerous. The Ministry of Health does not subscribe and indeed the Framework does not subscribe to that distinction… We’ve decided as a country, we have decided as a region, and indeed we’ve decided internationally that we have to fight back against these marketing forces,” he said.

Minister Boyce went on to say that the package and label will give full disclosure about the harmful and hazardous health effects through graphic pictorial warnings. These warnings, he said, will cover the front and back area of the product to a minimum of 60 per cent. In addition, Boyce said, there will be written warning attributable to the Minister of Health and or the Chief Medical Officer. The warnings, he explained, will speak to such health issues as blindness, impotency, and stillbirth, dangers of second hand smoke and mouth diseases.

He added that the standard for packaging and labelling was adopted out of a CARICOM standard approved by the Council of Health Ministers of the region, and facilitated by the CARICOM Regional Organisation for Standards and Quality and the Barbados National Standards Institution. That work, he stated, started as far back as 2013. (JRT)

Global tobacco control

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COSH urges the Government to take full account of public opinions Enact Enlargement of Pictorial Health Warnings Promptly

Hong Kong Council on Smoking and Health (“COSH”) urges the Government and Legislative Council to enact the enlargement of pictorial health warnings promptly in order to reduce the attractiveness of tobacco, motivate more smokers to quit and deter youth from trying the first cigarette. Mr Antonio KWONG, COSH Chairman remarked, “Results from survey conducted by COSH and two rounds of public consultations organized by the Legislative Council showed that majority of citizens and organizations supported the enlargement of pictorial health warnings to 85%. The Government and Legislative Council should take full account of public opinions and enact the proposed tobacco control measure as soon as possible.”

The Government briefed the legislative proposals to strengthen tobacco control on 18 May 2015, including enlarging the size of pictorial health warnings to at least 85% of the two largest surfaces of the packet, increasing the number of forms of health warning from six to twelve and adding the quitline 1833 183. The date of enactment is yet to be scheduled after more than one and a half years.

The Legislative Council collected views of the public and held special meetings on the enlargement of pictorial health warnings twice. Among the hundred submissions received in July 2015 regarding the increase in the size of pictorial health warnings, more than 80% supported. Besides, over 100 submissions were received for the special meeting of Legislative Council Panel on Health Services to be held tomorrow (17 January 2017), in which around 70% agreed the proposed measure.

The School of Public Health of The University of Hong Kong was commissioned by COSH to carry out the Tobacco Control Policy-related Survey 2016. It was found that public support on enhancing the pictorial health warnings was overwhelming, 79.5% of all respondents agreed to display more threatening messages about the health risks of smoking. About 72.5% of all respondents supported to increase the coverage of the health warnings to 85% while about half of the current smokers also supported. Majority of respondents opted for plain packaging* of cigarettes as well. In addition, COSH has collected over 26,500 signatures from citizens and organizations through street counters and online platform supporting the enlargement of pictorial health warnings since May 2015.

In recent years, many countries have successfully introduced more stringent measures to regulate tobacco packaging. Prof Judith MACKAY, Director of Asian Consultancy on Tobacco Control and Senior Policy Advisor of World Health Organization claimed, “Hong Kong ranked the 72nd in the world regarding the implementation of pictorial health warning and behind many developing countries like Laos, Myanmar and Sri Lanka. Hong Kong should enlarge and strengthen the pictorial warnings promptly in order to reduce the use of tobacco.” World Health Organization called for more countries to enlarge pictorial warnings covering more than 85% and implement plain packaging. “Get ready for plain packaging” was designated as the theme of World No Tobacco Day 2016.

Recently, some organizations opposed the proposed enlargement of warnings in the pretext that it would lead to a surge in cigarette smuggling activities. A recent study also claimed that illicit cigarettes composed for around 30% of cigarette consumption in Hong Kong. Prof LAM Tai-hing, Chair Professor of Community Medicine cum Sir Robert Kotewall Professor in Public Health, School of Public Health, The University of Hong Kong said, “the public should express reservation on the results of this tobacco industry-funded study. The data collection methods and calculations of the study were unclear using dubious methods.” The tobacco industry and its allies always express strong opposition against tobacco control measures proposed by the Government under the pretext that it will lead to a surge in cigarette smuggling activities. As recommended by the World Health Organization, the most effective measure against smuggling is tight control and aggressive enforcement.

With the Government’s multi-pronged tobacco control policies over the years, the smoking prevalence in Hong Kong has gradually reduced from 23% in early 80s to 10.5% in 2015. In view of the tobacco epidemic in Hong Kong and the international tobacco control trend, we urge the Government and Legislative Councilors to take account of public opinions and implement the enlargement of pictorial health warnings as soon as possible to safeguard public health. The Government should also actively consider adopting plain packaging within 2 to 3 years and develop long-term and comprehensive tobacco control policies including regulating the emerging tobacco products and e-cigarettes, raising tobacco tax substantially, expanding no-smoking areas, increasing resources on education, publicity, smoking cessation services and enforcement to further reduce the smoking prevalence in Hong Kong and protect people from the harms of smoking and secondhand smoke.

*Remarks: Plain packaging standardizes and simplifies the packaging of tobacco products. The pictorial health warnings on the main sides of cigarette pack are expanded. All forms of tobacco branding should be labeled according to the government prescriptions and with simple and plain format. This means that trademarks, graphics and logos are not allowed on cigarette packs, except for the brand name that is displayed in a standard font size, colour and location on the package. The packaging should not contain other colours and should include only the content and consumer information, such as toxic constituents and health warnings required by law. The quitline number should also be displayed at a prominent position. Australia was the first country to introduce plain packaging in 2012. The measure was also implemented in the United Kingdom, France and Hungary in 2016 and will be implemented in Ireland in 2017.

Bigger graphic health warnings on Hong Kong cigarette packs needed, anti-smoking group says

Survey finds most in favour of move, which advocates say can protect public health and encourage more to quit habit

An anti-smoking body has pressed the government to speed up legislation on cigarette pack health warnings after a survey revealed almost 80 per cent of people desired sterner messages on smoking risks.

The Council on Smoking and Health made the call ahead of another public hearing held on Tuesday in the Legislative Council to collect views on whether to implement the law.

The legislation will expand the size of health warnings on cigarette packs from the current 50 per cent to 85 per cent of the packaging surface.

The proposal was first submitted by the government in May 2015, and the first hearing was held in July in the same year.

According to a survey commissioned by the council and done between February and September last year, 79.5 per cent of 2,058 respondents – comprising smokers, non-smokers and ex-smokers – want cigarette packs to show clearer and more graphic warnings.

Another 72.5 per cent of them also want to see the graphic warnings enlarged to cover 85 per cent of the packaging surface, a move also supported by almost half of the smokers in the survey.

“The implementation work has dragged on for one and a half years. This measure can protect public health and help more people quit smoking.

“We hope that Legco will not procrastinate on the legislation any further,” council chairman Antonio Kwong Cho-shing said.

He said that Australia recorded a drop of 2.2 percentage points in average smoking rate after introducing plain cigarette packaging in 2012.

Of this amount, 0.55 percentage points, or 108,000 fewer smokers, were due directly to the new measure which only allowed brand names to be displayed in a standard font size, colour and position on the packaging, thereby making them less conspicuous and seemingly less desirable.

Professor Judith Mackay, a veteran tobacco control advocate and senior policy advisor for the World Health Organisation, said a larger graphic warning would have an even bigger visual impact and induce more smokers to quit.

According to a Canadian Cancer Society survey which studied the effectiveness of health warnings on cigarette packs worldwide, Hong Kong ranked 72nd out of 205 places.

“We used to be among the top 12 jurisdictions [in cigarette pack warnings] … now we are lagging very far behind from the international experience,” Mackay said. She has been working on tobacco control advocacy in the city for more than 30 years.

The survey done by the Canadian group looked at various factors, including whether graphic warnings existed on the packaging design, the sizes of the images and when the warnings were introduced.

Mackay attributed the city’s poor ranking partly to outdated warnings, which were first introduced in 2007, and the lack of information on helpline numbers for those seeking to quit the habit.

She said in the long run the government should also further increase tobacco tax to make cigarettes less affordable.

Kwong from the Council on Smoking and Health said it submitted a letter to the financial secretary late last year to suggest increasing tobacco tax to 100 per cent.

Clear The Air Request to Members to Show Support for 85% Graphic Health Warnings

Dear Clear the Air members and interested readers/researchers


This is an urgent request for support for the Hong Kong Government policy on upgrading the 2007 graphic warnings from 50% to 85% coverage of the area, doubling the number, and adding a quitline number – not that far off plain packaging.

Opposition from the vile and heinous child addicting tobacco industry has been intense, particularly as HK is seen as an exemplar for the Asia-Pacific region, with an effect more far-reaching than just the 7 million who live here.

The industry and their paid front groups are bombarding Government and Legislative Council with letters, and it would be very helpful and save lives if you could sign the (sample) letter below and send to Legco before 17th January 20917 when the important meeting will take place to discuss this important health prevention measure.

Send the email, you do not have to be a permanent resident of Hong Kong.

Date: 13th January 20917

Panel on Health Services
Legislative Council
Hong Kong Special Administrative Region, China

Re: 85% Graphic Tobacco Pack Warnings in Hong Kong
I/we support the Hong Kong government proposal to upgrade the current graphic pack warnings, to 85% coverage as outlined below.

I AGREE that my submission be made available to the media as per Legco requirements and the public and be uploaded onto the Legislative Council website.

Yours sincerely,





Contact email/verifiable details/:

Briefing paper from the government to Legco:
LC Paper No. CB(2)386/16-17(05)
The Proposal

3. At present, the Smoking (Public Health) (Notices) Order (Cap. 371B) stipulates that the health warning should cover at least 50% of the two largest surfaces of the packet or retail container of cigarette, cigar, pipe tobacco and cigarette tobacco in accordance with the prescribed forms and pictures. The existing batch of health warning pictures has been in use since 2007. The Government now proposes to change the prescribed forms of health warnings and the indication of tar and nicotine yields on the packet and retail container of cigarette and relevant tobacco products.

4. We propose to amend the prescribed forms (including specifications) of the health warnings, the size and number of the health warnings and messages for the packet or retail container of cigarettes and tobacco products under the Smoking (Public Health) (Notices) Order as follows –
(a) the area of the graphic health warning shall be of a size that covers at least 85% of two largest surfaces of the packet or the retail container;
(b) the number of forms of health warning will increase from six to
(c) the following health warning message is to be included in the
existing statement “HKSAR GOVERNMENT WARNING” / “香
港特區政府忠告市民” –
“請為你的下一代戒煙”; and
“QUITLINE: 1833 183” / “戒煙熱線:1833 183”;

(d) the indication of tar and nicotine yields should be printed on a side adjacent to a typical flip-top lid of a cigarette packet, excluding the portion which forms part of the lid and the two largest surfaces, presented in a conspicuous place of such side of
the packet.

RCPE Letter on Graphic Tobacco Pack Warnings in Hong Kong

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People Have Tried to Make U.S. Cigarette Warning Labels More Graphic for Decades

On this day in 1964, the surgeon general officially said that smoking causes cancer. But warning labels in America still don’t show its effects

Health warning labels on tobacco products are just one more proof of the expression “a picture is worth a thousand words.”

It’s been 53 years since a surgeon general’s report unequivocally linked cigarettes and cancer. Today, that conclusion seems completely obvious. But in the past it wasn’t, and the cigarette lobby (as anyone who’s watched Mad Men knows) worked hard to keep it that way. Even when that link was publicly drawn, the industry has worked to downplay it as much as possible, writes the World Health Organization. Today, that’s by fighting to keep their names on packages—and graphic images of the consequences of smoking off them.

“If it has not been proved that tobacco is guilty of causing cancer of the lung, it has certainly been shown to have been on the scene of the crime,” wrote Charles S. Cameron in the January 1956 issue of The Atlantic. In that article, he talks about the dramatic rise in lung cancer since 1900, and the potential reasons that have been advanced for it, but stops short of drawing the direct connection to cigarettes.

But the press of evidence grew, and talk of imposing health warning label requirements began in the U.S. in 1957, write researchers Heikki Hiilamo, Eric Crosbie and Stanton A. Glantz for the journal Tobacco Control. One 1959 bill in the South Dakota legislature would even have made tobacco producers put a skull and crossbones on their product, they write.

But eventually, the industry stopped blocking warning labels, as long as the labels carried only “vague health messages,” like that required by a 1965 Act: “Caution: Cigarette smoking may be hazardous to your health.” And through the rest of the twentieth century, successive generations of public health authorities and politicians around the world fought tobacco companies to place labels on more prominent areas of cigarette packs and make the labels larger and more eye-catching.

After European countries started talking about ways to make warning labels more effective in the 1970s and 1980s, in 1985 Iceland was the first to implement picture warning labels, according to a UC San Francisco press release.The tobacco industry worked hard to overturn those requirements, he writes, but the idea took off.

Picture warning labels could be as simple as an image associated with death, like a skull and crossbones, or as graphic as they are in many countries today: images of smokers’ lungs, decayed teeth, people dying of lung cancer and other images representing the suffering that can be caused—and to millions of people, has been caused—by smoking using tobacco products. No wonder they’re so effective.

In 2000, our northern neighbor Canada became the first country to use these kinds of upsetting photographs of cancer and disease on its cigarette warning labels, and other countries soon followed suit.

In 2011, writes UC San Francisco, it looked like the United States was going to join those countries, but a free speech-related lawsuit by tobacco companies and other factors have meant that to date, the change hasn’t happened.

“Health warning labels, especially labels with graphic elements, threaten the tobacco industry because they are a low-cost, effective measure to reducing smoking,” the researchers write.

Today, health advocates are fighting to have tobacco packaging be even less attractive using measures like requiring tobacco products to be sold in plain packaging and using the world’s ugliest color to turn people off.