Warning labels on cigarette packages in Canada, which feature disturbing images that include a diseased tongue and a child wearing an oxygen mask, are among the toughest in the world, but more needs to be done, such as plain packaging, to reduce smoking rates, according to a new report.
The Canadian Cancer Society published an international report Wednesday that comprehensively ranks cigarette warning labels in 198 countries and jurisdictions around the world. Rankings were based on the size of warnings on cigarette packages and whether countries have introduced picture warnings on packages.
Canada moved up to fourth in the world rankings in 2012, a major boost from 15th place in 2010. Although it's an improvement, Canada still hasn't reclaimed its top spot.
Canada was the first country in the world to introduce graphic warning labels on cigarette packages. But in 2010, the federal government announced it was shelving the introduction of larger warning labels with new graphic images. The CBC later reported the plan was halted after the tobacco industry lobbied the federal government. Soon after that report aired, Health Minister Leona Aglukkaq said the update would go ahead. The new warnings, which cover 75 per cent of cigarette packages, were rolled out earlier this year.
The leader of the pack in this year's survey is Australia, the first country to pass legislation requiring plain packaging on cigarettes in addition to graphic health warnings. In August, Australia's highest court dismissed a challenge from the tobacco industry, and the new packaging will be rolled out next month
Of the countries included in the report, 63 have finalized requirements for picture warnings on cigarette packages and 47 countries and jurisdictions have warning labels that cover at least 50 per cent of the package.
Now, the onus is on Canada to move forward with plans to introduce plain packaging here, said Rob Cunningham, a senior policy analyst with the Canadian Cancer Society.
"We urge the federal government to take steps toward implementing plain packaging in Canada," he said. "If Australia can do it and other countries are actively looking at it, Canada can similarly make steps to move forward."
"Plain packaging" means cigarette labels are stripped of any branding, colours or logos associated with a particular company. Starting next month, cigarette packages in Australia will feature text and a picture warning about the dangers of smoking, which will take up 75 per cent of the front of the package and 90 per cent of the back. The name of the company selling a particular brand of cigarette will be printed in plain type below the warning.
Organizations and smoking-cessation experts from around the world, including the World Health Organization, have applauded Australia's leadership and continue to urge other countries to follow suit.
Given that Canada was the first country to introduce graphic warnings on cigarette packages, there's no reason to delay implementing plain packaging here, said Neil Collishaw, research director of Physicians for a Smoke-Free Canada.
"The problem is not solved," Collishaw said. "The Australians are leading the way in that regard. Hopefully Canada will catch up."
The federal government should also follow through on its promise to put graphic warnings on other products, such as roll-your-own tobacco, smokeless tobacco and waterpipe tobacco, which is becoming increasingly popular among young people, Cunningham said.
Despite calls for action, Health Canada has no plans to move forward with plain packaging for cigarettes or stronger warning labels for other tobacco products, department spokesman Stéphane Shank said in an e-mail.
The introduction of graphic cigarette warning labels has led to a debate over whether they are effective. Many people simply purchase cases to cover up the labels, while others have argued that cigarettes are so addictive that a warning label isn't going to work. But several studies have shown that such labels accompanied by a graphic picture of a diseased mouth or lung, or a gaunt patient in a hospital bed, are highly likely to stick in an individual's mind and educate them about the risks of tobacco use.
To know whether cigarette warning labels work, Cunningham says to look no further than the tobacco industry's reaction. Cigarette manufacturers have launched legal challenges in several countries over graphic warning labels.
"The tobacco industry has opposed these warnings strongly," he said. "If they didn't work, the industry wouldn't be opposed."