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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 said, “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. We are disappointed that the date of enactment is yet to be scheduled after more than one and a half years. It is hoped that the meeting of Legislative Council Panel on Health Services to be held on 19 December 2016 will make concrete progress on the proposed enlargement of pictorial health warnings.”

Public support the enlargement of pictorial health warnings
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. Besides, the Legislative Council collected views of the public on the enlargement of pictorial health warnings as well as other tobacco control measures and Panel on Health Services held a Special Meeting on 6 July 2015 in which various parties give views on the proposals. Of around 100 submissions from different sectors of the society supporting the proposed tobacco control measures, majority agreed the proposal of increasing the size of the pictorial health warnings.

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, such as displaying more threatening messages about the health risks of smoking (79.5%), and regular rotation of the health warnings (69.9%). About 72.5% of all respondents supported to increase the coverage of the health warnings to 85%, and nearly four-fifths (79.2%) of all respondents opted for plain packaging* of cigarettes. Apart from the support from the majority of non-smokers, about half of the current smokers also supported these measures.

Reduce the attractiveness of tobacco
The existing six forms of pictorial health warnings covering at least 50% of cigarette pack area have been used since 2007 and their deterring effect has faded. International research and experience has proved that pictorial health warnings can reduce the attractiveness of smoking, increase intention to quit, and deter youth from smoking. Larger warnings can educate smokers and the public on the health hazards of smoking, as well as prevent the tobacco companies from using gorgeous cigarette packs and massive products display at points of sale for promotion, so as to reduce the influence of tobacco brands to the smokers.

Global trend: plain packaging and larger pictorial warnings
In recent years, many countries have successfully introduced more stringent measures to regulate tobacco packaging. Australia, the first country to introduce plain packaging in 2012, has resulted in a substantial decrease in the smoking population. It proved that the measures effectively raised the intention to quit and prevented youth from smoking. Plain packaging was also implemented in the United Kingdom, France and Hungary in 2016, and will be implemented in Ireland in 2017. More countries are considering to adopt. On the other hand, many countries have enlarged the coverage of pictorial health warnings of cigarette packs, including Nepal (90%), India (85%), Thailand (85%) and Uruguay (80%). The effectiveness of these measures has provided strong evidence and urgency for such approach in Hong Kong.

Dr Margaret CHAN, Director-General of World Health Organization (“WHO”), highlighted the success of plain packaging to tackle the tobacco epidemic at the 16th World Conference on Tobacco or Health in March 2015, and she called for more countries to adopt plain packaging or pictorial warnings covering more than 85% by 2018. WHO also designated “Get ready for plain packaging” as the theme of World No Tobacco Day 2016.

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 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, 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.

* 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.

Photo Caption

Future tobacco products display at newspaper stall (pictorial health warnings enlarged to 85%). Attractiveness of tobacco is reduced (especially to the youth) and products display at points of sale for promotion is prevented due to the clearer pictorial health warnings. (mock up in the photo)
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