best practices: pictorial health...
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Best practices: pictorial health warning
Tara Singh Bam
Deputy Regional Director
International Union Against Tuberculosis and Lung Disease (The Union), Singapore
Our future is not written,we have to write our future where everyone can enjoy a healthy and prosperous life
Pictorial Health Warnings are effective
•Educate people on danger of tobacco use
•Motivate smokers/tobacco users to quit
•Convince youth not to start smoking/tobacco use
•Re-convince ex-tobacco users to remain quitter
Countries requiring picture warnings on cigarette packages-2017
1 2 2 3 511 12
18
26
3440
55
63
70
77
102105
0
20
40
60
80
100
120
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Source: Cigarette packaging health warnings. International Status Report 2016, Canadian Cancer SocietyGlobal Tobacco Epidemic 2015. World Health Organization
50%+Countries/jurisdictions requiring warnings of at least 50% of package (on average)
2432
46
66
94
0
10
20
30
40
50
60
70
80
90
100
2008 2010 2012 2014 2016
Source: Cigarette packaging health warnings. International Status Report 2016, Canadian Cancer SocietyGlobal Tobacco Epidemic 2015. World Health Organization
Pictorial Health Warning in South and South East Asian Countries
90%85% 85%
80%75% 75% 75%
55% 55%50% 50% 50% 50%
40%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Source: Cigarette packaging health warnings. International Status Report 2016, Canadian Cancer SocietyGlobal Tobacco Epidemic 2015. World Health Organization
Evidences
Nepal 90% Thailand 85% India 85% Sri Lanka 80%
Brunei 75%Myanmar 75%
Larger Pictorial Health Warning
Malaysia 55%Lao PDR
Larger pictorial health warnings are effective PHW made the smokers to reduce cigarettes smoked/day
Indonesia Nepal
Source: Indonesian Public Health Association, 2015 (N=5355, current smokers – 1901)Action Nepal and Nepal Health Research Council, 2015 ( N = 2250, current smokers - 670)
15
11
0
2
4
6
8
10
12
14
16
Cigarettes smoked(text warnings)
Cigarettes smoked(PHW)
11
5
0
2
4
6
8
10
12
14
16
Cigarettes smoked(text warnings)
Cigarettes smoked(PHW)
27%
55%
India Evidences
• There is remarkable decline of 54 %, 33 % in the tobacco use among 15-17, 15-24 age groups respectively.
34.60%
28.60%
0%
5%
10%
15%
20%
25%
30%
35%
40%
2010 2017
Remarkable decline of tobacco use
Source: Global Adults Survey 2017
Australia: Evidences proved that PHWs are effective
In Australia, PHWand plain packaging was found effective. Number of adolescents currently smoking reduced by more than 70 per cent, from 23.5% in 1996 to 6.7% in 2014
23.50%
6.70%
0%
5%
10%
15%
20%
25%
1996 2014Source: Dessaix A et al Public Health Res Pract. 2016
Myanmar- Comparison between text and pictorial health warning in building public awareness on danger of tobacco use
34.1%
85.9%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Textwarning
PictorialWarning
Not scary Scary
37.6%
88.1%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Textwarning
Pictorialwarning
Not scary Scary
Adult population Youth population
Source- Ministry of Health, Myanmar 2014
Retailers support Pictorial health warnings policies and implementation
•84.6% of the retailers support government policy on pictorial health warnings
•90% of the retailers were found selling cigarettes with pictorial health warning
•92.6% of the retailers support government policy on pictorial health warnings
•99.3% of the retailers were found selling cigarettes with pictorial health warnings
Indonesia (N = 1425) Nepal (N = 270)
Source: Tobacco Control Support Centre, Indonesian Public Health Association, 2015 Action Nepal and Nepal Health Research Council, 2015
Indonesia: RI farmers support tougher tobacco control, study says -
62.5%
83.3%70.4%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Current tobaccofarmers
Ex-tobacco farmers All
Don't know
Not support
Support
Source: http://www.thejakartapost.com/news/2015/10/28/ri-farmers-support-tougher-tobacco-control-study-says.html#sthash.GYBfj6fJ.dpuf
Muhammadiyah University Yogyakarta, October 2015
Summary
• Larger PHWs are more effective
•All segments of community support PHW; public, youth, retailers and tobacco farmers
•PHW is the most cost effective strategy – No cost to government, easy to implement and monitor –Government commitments
What do we need to do?
Nepal 90% Brunei 75% Australia Plain PackagingIndonesia 40%
Cigarettes produced in Indonesia carry a 90% pictorial health warning on packaging for Nepal, 75% PHW for Brunei and plain packaging for Australia
? Why not for Indonesia
Indonesia: Let’s join hands together to increase a size pictorial health warning to at least 75%
40% PHW 90% PHW Plain packaging
Indonesia Nepal Australia