From Tobacco Info No. 5 - April 2011
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Health Canada unveils all proposed health warnings

Following up on its December announcement to renew pictorial health warnings on cigarette packages, Health Canada unveiled on February 19 a set of 16 new images and written warnings that it has proposed for public consultation.

“Health Minister [Leona] Aglukkaq deserves strong praise for moving forward on this major public health initiative,” said Rob Cunningham, Senior Policy Analyst with the Canadian Cancer Society. “In introducing the new set of larger, enhanced warnings, the government is demonstrating world leadership.”

The new label warnings will cover 75% of both the front and back of the packages, an increase from 50%. In addition, eight messages will be printed on the inside of the packs or on an insert, with four different and improved toxic emission messages for the side panel.

The enhanced warning system will also include testimonials, most notably images featuring the late Barb Tarbox on her deathbed due to lung cancer, as well as Leroy Kehler, who speaks through a hole in his throat using a voice box following cancer of the larynx.

“A picture says a thousand words,” said Cunningham. “These picture warnings will help tell the truth about tobacco products and contribute to reductions in both smoking and cancer.”

In addition, a toll-free quitline phone number and web address will be incorporated into the label, providing assistance to those wishing to obtain help for their addiction. International data demonstrates that calls to quit lines increase substantially when a toll-free number is added prominently to the package. According to a 2007 study by the European Quitlines Network, a significant and relatively strong impact on quitline call volumes occurred in the first year after their introduction to cigarette packs. In the second year, this impact generally was substantially less strong, yet call volumes were still significantly higher than before the quit lines’ introduction.

Also, for the first time, warnings about certain health effects, like bladder cancer and vision loss, which were not part of the first round of warnings, will be included.

Garfield Mahood, Executive Director of the Non-Smokers’ Rights Association said that in many respects the new warnings represent a significant step forward: the increase in size to 75% of both major faces, the inclusion of stronger graphics, such as the two Barb Tarbox warnings, and the addition of the toll-free quitline number and web address. 

Mahood, who played a significant role in the development of Canada’s landmark tobacco warning systems in 1994 and 2001, is deeply concerned, however, that the proposed new warnings have lost key elements of Canada’s current world precedent-setting system. Most of the new warnings fail to fulfill a basic requirement of tort law in Canada, that is to warn consumers of both the nature of the risk (e.g. cigarettes cause lung cancer) and the magnitude of that risk (e.g. more than eight in 10 people with lung cancer die within 5 years). Of the 12 new warnings, eight fail to warn of the most serious danger that tobacco can kill. Another significant loss in the proposed warnings is a reduction in the variety and impact of the interior package messages. Sixteen interior messages that now include a mix of more detailed health risk information and cessation support have been reduced to eight messages that focus exclusively on quitting.

Mahood believes that these shortcomings could be addressed before the final warnings are published in the Canada Gazette Part II if there was political will to do so. With almost two months remaining in the consultation period, Mahood is hopeful that health groups will impress upon Health Canada the need to make the package warnings system as strong, comprehensive and effective as possible. (Visit www.tobaccoinfo.ca/mag5/nsra.htm for Mahood’s complete critique.)

Canada Gazette

Health Canada’s February press release about the new set of warnings coincided with the publication of the Canada Gazette Part I of draft amendments to the Tobacco Products Information Regulations.

In the report, a cost-benefit analysis estimated that the costs of the proposed regulations would range from $74.1 million to $83.3 million over a 10-year period. Government costs would be approximately $11.7 million over a 10-year period, and industry costs would range from $62.4 million to $71.7 million.

The analysis estimated that the benefits of the proposed regulations would range from a value of $3.9 billion to $12 billion over a 10-year period. These benefits would accrue from the reduced morbidity and mortality effects on former smokers who successfully quit. Other potential beneficial impacts include reduced exposure to second-hand smoke, reduced loss of life and damage from cigarette-induced fires and improved quality of life for former smokers. Additionally, Canada is a party to the World Health Organization’s Framework Convention on Tobacco Control, and the country has an obligation to implement the requirements for displaying health-related information on tobacco products as set out in Article 11.

By Joe Strizzi