Pakistan oceans away from plain packaging of tobacco

Islamabad

While the World Health Organization (WHO) is recommending plain packaging as the next step for all smoked and smokeless tobacco products, Pakistan unfortunately is still oceans away from enforcing any such measure. The country’s Ministry of Health has not only surrendered from its global commitment to increase the size of the pictorial health warning on cigarette packs from the existing 40% to 85%, but has also failed to enforce rotation of the graphic warning every six months. On the contrary, it continues to demand and accept ‘special crested filter cigarettes’ that are ‘specially manufactured for the Aiwan-e-Sadr’ or the Presidency.

Not very long ago, on February 11, 2015 to be precise, Pakistan’s Ministry of Health captured global acclaim by announcing the government’s decision to increase the size of the pictorial health warning on cigarette packs to 85% with effect from March 30, 2014. On June 11, 2015, the minister of state for health Saira Afzal received the top WHO award on behalf of WHO director general Dr. Margaret Chan for her “outstanding leadership to the tobacco control initiative.”

Nobody knew how short-lived this celebratory period will be, because suddenly on July 25, 2015, the Ministry of Health surrendered from its global commitment, and succumbing to the pressure of the tobacco industry, consented to an incremental 10% increase in the pictorial health warning each year. Ironically, even this tiny measure is yet to be implemented.

By retracting from its commitment, Pakistan wholeheartedly allowed the tobacco industry to continue to jeopardize public health in a country where over 100,000 people die of tobacco-related illnesses each year. Furthermore, the Ministry of Health also aligned itself with the tobacco industry’s plea to hold a survey to ascertain if increasing the size of the pictorial warnings actually leads to tobacco cessation, or encourages use of smuggled cigarettes instead.

Ironically, both the Ministry of Health and the Tobacco Control Cell have loads of scientific evidence (provided to them by WHO) substantiating that larger pictorial warnings do have a greater impact in deterring new smokers and discouraging chronic ones. There is absolutely no need to re-invent the wheel by holding further surveys. Moreover, the Global Adult Tobacco Survey (GATS) also offers Pakistan-specific data which reflects the need for stricter controls on tobacco use.

However, now that the WHO is propagating plain packaging, Pakistan should forget about increasing the size of the pictorial health warning or its six-monthly rotation, and focus instead on prohibiting the use of logos, colours, brand images and promotional information on cigarette packaging. It should now follow in the footsteps of Australia, which became the first country to fully implement plain packaging in December 2012.

According to a WHO press release, “Australia’s post-implementation review shows that an additional 0.55 percentage point fall in smoking prevalence among those aged 14 and above was attributable to the packaging changes between December 2012 and September 2015. According to Australia, this equates to more than 108,000 people quitting, not relapsing or not starting to smoke during that period.”

The WHO believes that the introduction of plain packaging can save lives by reducing demand for tobacco products. Plain packaging restricts or prohibits the use of logos, colours, brand images and promotional information on packaging. It only allows brand and product names displayed in a standard colour and font style.

“Plain packaging reduces the attractiveness of tobacco products. It kills the glamour, which is appropriate for a product that kills people,” says WHO director general Dr. Margaret Chan.

The theme of this year’s World No Tobacco Day, ‘Get ready for plain packaging,’ highlights this new trend in global efforts to control tobacco products, which kill almost 6 million people annually, notes Dr. Douglas Bettcher, WHO’s director for the Prevention of Non-Communicable Diseases. “The tobacco industry has been getting ready for plain packaging for some time, conducting massive misinformation campaigns to block the measure,” Dr. Bettcher adds.

In a message on the occasion, WHO’s regional director of the Eastern Mediterranean Region Dr. Ala Alwan states how for years, the tobacco industry has made use of the “glamour” of the tobacco package to entice children and young people to use tobacco. Every year, nearly 6 million people worldwide die from tobacco use and exposure to second-hand smoke.

“Plain packaging is one of the important measures that will contribute to reducing the demand for tobacco. On this World No Tobacco Day, policy-makers, civil society and the public can take action to ensure that their governments work towards exploring the possibilities of plain packaging. The next step in packaging and labeling, for many countries, is plain packaging,” Dr. Alwan concludes.

As far as Pakistan is concerned, it needs to immediately study the new guide that WHO has launched for plain packaging of tobacco products. This document gives governments the latest evidence on implementing the measure. The need for the Ministry of Health to conduct a survey to determine whether larger graphic health warnings really do have the desirable impact on tobacco control is over. The focus now should be on nothing short of plain packaging.