Scaring smokers to health found to be ineffective: time for a new approach to health warnings?

Graphic health warnings on tobacco products are not mandatory under the WHO Framework Convention for Tobacco Control. Yet a growing number of countries plan to introduce such warnings on the premise that by doing so, more smokers will be encouraged to quit than would be the case if existing text warnings were retained. However, according to a recent news article, a Health Canada poll has found that graphic health warnings are increasingly seen by Canadian smokers as being ineffective in this regard. Canada was the first country in the world to introduce graphic warnings back in 2001 and the results of the poll are seen by some as indicating that the existing warnings simply need refreshing. This could be so, but an alternative interpretation is that graphic health warnings fail in their purpose because they provoke outright denial, rather than fear, of the consequences of smoking. Also, from a harm reduction perspective, graphic health warnings do not steer smokers towards forms of tobacco and/or nicotine products such as smokeless tobacco, which are now widely considered to be much safer than cigarettes – it’s very much a ‘quit tobacco or die from a grisly death’ message. An alternative approach could be to use the health warning space on the packs to provide the consumer with less threatening information that might encourage him/her to move down the continuum of risk posed by different product formats. For example, packs of cigarettes could perhaps carry a health warning that simply says “Much safer nicotine-containing tobacco and non-tobacco products are available “. Following the same logic, cans of smokeless tobacco might carry a health warning that says “Safer non-tobacco nicotine-containing products are available” Nicotine replacement products might carry a health warning that says” Whilst this nicotine-containing product is safer than tobacco products, no product that contains nicotine is totally safe” Obviously one would have to do a fair amount of consumer research to get the vectored messaging right –but it’s a thought!   What do you think?    How might consumers react? How might governments react?


#1 outside1 on 07.08.08 at 9:34 AM

Found this last night

would it be included ?

#2 adrian on 07.08.08 at 10:43 AM

I don’t see why not – it’s quite possible that the tobaco/nicotine market will undergo extensive segmentation in the future, with the consumer having a far greater range of products to choose from that are currently available. That’s why it’s important for smokers to be given accurate and meaningful information about relative harm to help them make healthier choices if that is what they want to do rather than quit entirely.

#3 smokey on 07.08.08 at 4:37 PM

I’m wondering after reading the post how one can help the situation. I meam how can a few folks that understand the issues get the message across carefully but yet accurately?

#4 Native Son on 07.08.08 at 6:19 PM

I have often done business in canada selling cigarettes and folks just ignore the warnings. Put the match pack in the cellophane and just don’t think about it. It really does make sense to be more senseable in letting people know there are options rather than just have them ignore. The more you tell someone not to only makes some want to still do what they desire!

#5 outside1 on 07.10.08 at 1:25 AM

Back to the Nicotine Water for a second. Most anti-smoking images I have seen depict images of tar covered people. If one of the major selling points of a product is “zero tar” then what image would apply, if any ?

#6 adrian on 07.10.08 at 8:47 AM

As for Nicowater, maybe no image (no tar) just text to convey relative risk versus cigarettes/smokeless tobacco. Of course smokeless tobacco does not generate ‘tar’ either -you only get ‘tar’ from combustible products when you light them. That’s not to say that there are not chemicals of concern in the juices from smokeless products, there are, but much less than in cigarettes. Perhaps colours would help – rather like the traffic light symbols on food in the UK. Red for cigarette, orange/yellow for smokeless tobacco and green for nicotine containing non-tobacco products. Only problem with that in reality the risks of most types of smokeless tobacco are much closer to NRT products rather than cigarettes. It’s the smoke that is the real problem. Some public health campaigns have centered on this, but none (as far as I am aware) have given the consumer any information about alternatives other than NRT or quitting altogether. It’s like saying to a fast driver ‘you are using too much gasoline and it’s a valuable commodity – either switch to an electric car (maybe too expensive) or quit driving completely (maybe too impractical)’ The simplest and most effective thing might be to say ‘drive more slowly/more considerately’

#7 Chris Crawley on 07.10.08 at 10:49 AM

My experience suggests graphic health warnings lose their effectiveness very quickly. Consumers become oblivious to the warnings in a matter of weeks.

To illustrate this take Brazil, which now has a variety of rotating graphic health warnings. One includes an image of a cigarette with a drooping ash and a health warning informing you that cigarette smoking causes impotence. This is not something the average Brazilian male wishes to hear!

So what happens…………?

He refuses to buy the pack with the impotence image on it and opts instead for the one showing a diseased lung or any other image but that one!

Are graphic health warnings effective in the long term? Probably not.

#8 Adrian on 07.10.08 at 11:43 AM


I agree with you, but it’s not just that they lose their impact – they can be counterproductive. I remember taking part in a televison programme on smoking and impotence. During this programme I tried to make the point that when it comes to warnings (graphic or not) that smoking causes impotence, many male smokers do a simple reality check -find that they are not suffering from this and therefore there is a chance that other warnings about lung cancer and heart disease are ignored. It comes down again to trying to scare the smoker into health -by any means possible. It’s the same as having road signs up saying speed cameras, when there simply aren’t any. I think it’s time that smokers were treated like adults rather than children!

#9 CIG GUY on 07.11.08 at 1:39 AM

I typically enjoy a smoke after my woman and I experience one of the joys of life! No problem here! Probably some guy who has no sex life and blames it on the Virginia Slim 120 he smokes.

#10 Troubadour on 07.24.08 at 10:38 PM


Any thoughts on HR 1108 as it would seem nicotine water would not be touched?

#11 outside1 on 07.30.08 at 8:53 PM

Nicotine water is alredy under the FDA regulatory umbrella, so the bill would have no bearing.

A wise law that does apply to Nicotine Water is a New York law that requires any water containing nicotine to be sold in the same manor a tobacco products.

While not widely know, just because a product contains nicotine does not make it an 18 and over product.

#12 Troubadour on 09.11.08 at 10:03 PM

Amazingly, I found out the other day that in Canada that the warnings and the lack of displays has not decreased volume as one would have thought! Was the report wrong or am I mistaken?

#13 Adrian on 09.12.08 at 5:58 AM

Troubadour -can’t speak to the impact (or lack of) of displays, but it is pertinent that despite Canada being the first country to introduce pictorial warnings, smoking prevalence has over the last three years remained pretty static. You can see this from the Health Canada report at

#14 Troubadour on 09.12.08 at 9:44 AM

Adrian, I appreciate the info, pretty interesting to see that as I was told the graphic warnings do very little to curtail smoking. Just seems like another area the mislead public health organizations mislead the public.

#15 Brave heart on 10.16.08 at 1:07 AM

I was talking with a few folks from Canada and they say that the graphic warnings are useless in stopping people from smoking! They told me “I can’t do something and it makes me wanna do it more” was one comment I heard!

#16 Bill Godshall on 10.20.08 at 4:30 PM

In countries that require color graphic warning labels on cigarette packs, cigarette consumption has declined significantly for several years following implementation of the law, but then the impact of the warnings wear off.

I strongly support color graphic warnings on cigarette packs (as long as the information is accurate), but not for cigars or smokeless tobacco products (as their usage poses fewer health risks).

#17 Adrian on 10.21.08 at 6:27 AM

Take the point, but I still remain to be convinced that increasingly graphic warnings are themselves responsible for drops in smoking prevalence given other factors that are likely involved. I have had the same kind of conversations that Brave Heart refers to above. But if cigars and smokeless tobacco products were differentiated by not having such warnings then yes, it might help steer consumers down the risk continuum. Trouble is, in the eyes of many tobacco control advocates, all tobacco use if bad-we only have to look to World No-Tobacco Day 2006 to see that! I guess that’s why I think it’s important for smokers to get non-threatening guidance messages on packaging rather than the orthodox quit-or-die mantra, which risks prompting denial or exactly the opposite behaviour intended

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