Get ready for the plain packaging of tobacco products

Op-ed by Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region

Tobacco remains a major killer across South-East Asia. Plain packaging can change that.

The tobacco epidemic continues to rage across the WHO South-East Asia Region. Nearly 246 million adults Region-wide smoke this cancer-causing agent, while just below 290 million consume it in a variety of smokeless forms. This results in approximately 1.3 million deaths across South-East Asia every year. That’s 150 deaths per hour.

Change is needed, and now. One of the most powerful ways to curb tobacco use is to regulate the advertising of tobacco products. And one of the most powerful ways tobacco companies promote their products is via packaging. In the struggle to free our countries of the tragic, costly and unnecessary burden of tobacco use, the plain packaging of tobacco products is an important weapon.

Plain packaging, also known as ‘standardized packaging’, means that logos, colors, brand images or promotional information is removed from tobacco packaging. Instead, tobacco packaging features black-and-white or other contrasting color combinations, and a brand name, a product name and/or a manufacturer’s name. Astride the package’s drab exterior are graphic health warnings documenting tobacco’s adverse effects, including desiccated, cancerous lungs; gangrenous limbs; and asthmatic children. The net result is a product that is significantly less appealing.

Australia is the pioneer of the plain packaging initiative, and has been enforcing it since December 2012. Research shows that plain tobacco packages are of diminished appeal to a substantial proportion of smokers, and have resulted in declining rates of tobacco use. Plain packaging, in tandem with other tobacco control initiatives, has meant that Australia’s daily smoking rate among persons 14 years and older declined from 15.1% to 12.8% between 2010 and 2013. Many countries now aspire to pass similar legislation and make the plain packaging of tobacco products mandatory. At present, three other countries have done this – France, the United Kingdom and Ireland. Many more are expected to follow.

Importantly, the passage of plain-packaging legislation to date has been limited to high-income countries. This needs to change. While tobacco consumption is on a downward trend among these countries, the opposite is true in low- and middle-income countries. The developing economies of the South-East Asia Region remain key markets for Big Tobacco, who will fight tooth-and-nail to retain influence and brand loyalty to maintain and expand their markets. The cost of allowing this to happen is immense, and will be borne society-wide. Economies will be less productive; health care costs will increase; and the tobacco-poverty cycle will be entrenched.

To be sure, important steps have been taken to control tobacco use across the South-East Asia Region. Ten of the Region’s 11 member countries are Parties to the WHO Framework Convention on Tobacco Control. And each country has passed and implemented tobacco control legislation in line with the Convention’s provisions. Nepal, for example, has decided to have health warnings cover 90% of the principal display area of tobacco packs, while in Thailand health warnings cover 85% of cigarette packs on both sides. India has recently increased the size of warnings from 40% on the front to 85% on both sides of all tobacco products packs.

Despite these and other advances, there is considerable room for improvement. Children, youth and adults in countries across the Region continue to be subjected to pro-tobacco messages in media. They also often encounter product advertising at outlets where tobacco is sold. Our commitment to addressing the tobacco epidemic must be renewed. New initiatives must be considered.

The Seventh Session of the Conference of Parties to the WHO Framework Convention on Tobacco Control (COP7), hosted by India in November 2016, will be an opportunity to do just that. The conference provides an important forum to help fine-tune and enhance tobacco control measures across the Region, as well as to discuss and emphasize the utility of plain packaging. Plain packaging is already being considered by lawmakers in India, and will become a key tool for tobacco control partners and stakeholders from across the Region. It is an initiative that will only gain momentum.

Beyond a desire to protect the profit margins of Big Tobacco, there can be no reason to oppose plain packaging. With plain packaging in place individuals will remain as free as ever to consume tobacco products, but will be more empowered to decide otherwise. The psychology of consumption will be disrupted and new patterns of behavior will emerge. This will help our friends and family live longer, healthier and happier lives. It will also increase economic productivity and lessen the substantial burden tobacco-related illnesses represent to health services and taxpayers.

On World No Tobacco Day we must all reflect on the harm tobacco causes and open ourselves to new and innovative ways to challenge its grip over individuals, communities and countries. We must all get ready for plain packaging.