Health warnings on cigarette packets were first imposed by federal law in 1989, at which time there were four text-only messages. This was a huge improvement over previous voluntary warnings, which in Canada included the laughable advice to smokers to “Avoid Inhaling.”
In 1994, a new set of eight messages came into effect. These warnings occupied the top 35% of each main display surface of a cigarette pack, and are very blunt:
- “Cigarettes cause fatal lung disease”
- “Cigarettes cause strokes and heart disease”
- “Tobacco smoke causes fatal lung disease in non-smokers”
- “Cigarettes are addictive”
These warnings quickly spread around the world, and the Canadian system was adopted in countries such as Australia, Thailand and Poland. The 1994 warnings have inspired legislative proposals in the United States and, most recently, in the European Union.
However, in 1995, the Supreme Court of Canada ruled large parts of the Tobacco Products Control Act (TPCA) unconstitutional, removing the legal basis for imposing the health warnings. In particular, the court accepted the tobacco industry argument that companies should have the right to attribute the warnings to the federal government, rather than print them unattributed.
On the heels of the TPCA decision, manufacturers opted to continue printing the warnings on their packets, though some chose to add an attribution (“Health Canada,” i.e. the federal Department of Health). This was likely because the industry realized that removing the warnings could hurt them seriously in court, if they were later sued for deceptive marketing or selling a defective product.
In 1997, Parliament passed the Tobacco Act, re-imposing restrictions on tobacco advertising and giving the government the power to regulate cigarette packaging and content.
Soon after, major health groups (including NSRA) spearheaded the formation of the National “Tobacco OR Kids” Campaign to press for effective regulations under the Act — including effective, mandatory health warnings.
In January 1999, the federal government unveiled a set of text-only messages to kick off public discussion on a new system of warnings. Though these messages would have occupied 60% of each main panel of cigarette packs, they were criticized for not using illustrations or photos and for being too scientific in style.
A few months later, “Tobacco OR Kids” responded with its own proposal: a set of blunt, plain-language warnings, with photographs, of the various dangers of tobacco products. Mockups of these warnings were printed up and given to MPs and other decision-makers.
In January 2000, federal Health Minister Allan Rock unveiled a new set of warnings similar to the “Tobacco OR Kids” proposal: plain-language warnings with photos on the outside of cigarette packs, and further information (in particular about quitting) inside the packaging.
After several further rounds of consultations, regulations under the Tobacco Act were published in the Canada Gazette and submitted to the House of Commons Standing Committee on Health in May 2000. The committee unanimously decided to support the regulations as proposed, a decision confirmed by the full House on June 8th.
The new regulations became law on June 26th. Manufacturers had until Dec. 23rd, 2000 to put the warnings on brands with a market share of 2% or more; for smaller brands, the deadline is six months later.
The federal government has won a first legal battle to protect the new warnings system. See: “Québec Superior Court rules in government’s favour: tobacco companies fail in bid to block new health warnings.”
- There are both outside and inside warnings. The top 50% of each of the two main panels of cigarettes packets must be used for the outside health warning — one in English, one in French. (There are similar requirements for other tobacco products, such as pipe tobacco, cigars and chewing tobacco.)
- Each outside warning includes an illustration (usually a photo), a marker word (“WARNING”) in red or yellow, a short, summary sentence (e.g., “CIGARETTES ARE HIGHLY ADDICTIVE”), and a brief explanation (e.g., “Studies have shown that tobacco can be harder to quit than heroin or cocaine.”). For cigarettes, 16 warnings have been mandated; the selection of warnings is smaller for other tobacco products, which comprise a very small portion of the Canadian market.
- Inside each pack, manufacturers must include one of 16 more detailed messages, each of which is about five paragraphs long. Half the messages provide information about quitting; the other half provide more detailed information about the health damage caused by tobacco. For example, one warning answers the question, “Can tobacco cause brain injury?”
||An example of an inside warning
The new health messages have attracted media attention around the world, with most journalistic reports focussing on the use of graphic photographs. “Canada to require grotesque new tobacco labels” (Reuters, June 28th) is a typical headline. This has led some people to conclude that the purpose of the new warnings system is to “scare smokers into submission,” or to prevent young people from trying cigarettes through gory pictures.
In fact, the primary purpose of the new warnings is to provide information in a meaningful way. In Canada, most consumers have a general awareness that “smoking is bad for you,” and the association between cigarettes and lung cancer or emphysema is strong in the public mind. However, few consumers are aware of the magnitude of the risk: cigarettes kill about one out of two long-term users, making smoking vastly more dangerous than driving a car, crossing a street, breathing city air and so on.
Consumers are also unaware of many of the specific health conditions caused by tobacco: cancers other than lung cancer, strokes and heart attacks, impotence and gangrene, just to name a few. How many people realize, for example, that tobacco-caused cardiovascular disease kills more people than lung cancer?
On the issue of second-hand smoke, medical authorities in numerous countries agree that there is a serious health risk for exposed non-smokers. But the tobacco industry has disputed these findings so vigorously — sometimes through underhanded funding to supposedly independent scientists — that public awareness of these risks isn’t as high as it should be. Five of the new warnings deal specifically with the health effects of tobacco smoke on non-smokers.
Do smokers need this type of blunt, detailed message?
Cigarette manufacturers have a long history of ignoring their obligations to their customers, playing down the health damage caused by tobacco, and attempting to drown out health information through widespread advertising designed to reassure consumers that cigarettes are normal products with glamorous overtones.
Indeed, because of this history of deception, the tobacco industry has faced hundreds of lawsuits in many countries. U.S. tobacco companies eventually had to agree to fork over billions of dollars per year in damages to state governments.
It is difficult to communicate information to consumers through this thick fog of misinformation. Especially because those who are addicted to tobacco may, very naturally, tend to ignore information about health issues that makes them feel uncomfortable.
Despite this discomfort, one particularly interesting thing to note about the new Canadian warning system is the very positive reaction from smokers in focus groups. Most smokers wish they didn’t smoke, and a large proportion plan to quit in the near future. (The tobacco industry’s own polling data from the 1970s and 1980s show this has been the case for a long time.) Especially if health warnings are introduced along with serious attempts to provide other types of help to prospective quitters, smokers are quite supportive.
- Low-resolution scans of the new warnings, as well as high-resolution scans suitable for print reproduction, are available on the NSRA site.
- In its Winter 1999 issue, the journal Tobacco Control published a cover article on Canadian health warnings by NSRA executive director Garfield Mahooda cover article on Canadian health warnings by NSRA executive director Garfield Mahood.
- Health Canada has a new website, set up specifically to go with the warnings, to provide further information to smokers.
- Health Canada’s Bureau of Tobacco Control has extensive information about the new labelling system on the tobacco legislation and regulation section of its website. This includes the text of the labelling regulation, as well as the source document showing what the new outside warnings should look like and the source document for inside warnings on slides and leaflets.
- Health Canada’s current tobacco research page includes several interesting reports on focus-group testing and other studies conducted in developing the new system.
- Proceedings from the Standing Committee on Health (May 30th through June 7th, 2000) include testimony from Health Canada, health groups, industry representatives and others.
- The Canadian Cancer Society put together six binders of material (academic papers and other documents) in advance of parliamentary hearings. A summary of evidence regarding the impact of tobacco products warnings and labelling, as well as a table of contents of the full submission, are available as Word documents, but appear to be temporarily off-line.
- The National Clearinghouse on Tobacco and Health had a web page on the world precedents set by the new Canadian warnings, but it is also temporarily unavailable.