Evidence
A wide variety of studies have demonstrated the superiority of using pictures and imagery in
health communications, rather than text-only messages. Health warnings with pictures are significantly more likely to draw attention and result in greater processing, and memory of the accompanying text. Picture warnings also encourage individuals to imagine health consequences and are more likely to be accessed when an individual is making relevant judgments and decisions.
Experimental research on cigarette pack warnings has also found that picture-based warnings are more likely to be rated as effective versus text-only warnings, both as a deterrent for new smokers and a means to increase cessation among current smokers.38,39 Opinion surveys in most ASEAN countries also showed that majority of smokers and non-smokers perceived that a combination of textual and pictorial health warnings is more effective in educating public about health risk of smoking and encourage quit attempt among smokers.40-44 Extensive focus group testing and market-research commissioned by government health agencies also underscores the importance of using pictures in package health warnings.
| “Graphic” Fear-Arousing Messages Are Most Effective Health warnings that arouse strong emotional reactions are most likely to be effective. Smokers and non-smokers, as well as youth and adults consistently identify images that depict graphic health effects as being the most memorable and the images that are most likely to prevent smoking or motivate quitting. A study of 1,300 smokers and non-smokers in Singapore found that images of smoking causes lung cancer and stroke were rated to provide the highest impact in encouraging smokers to quit smoking or discouraging non-smokers from taking up smoking. However, there are a number of different themes that may evoke strong emotional reactions that do not involve pictures of diseased organs. Recommendations for content are available in the Tobacco Labelling Toolkit at www.tobaccolabels.ca. |
Picture Warnings Are Credible and Are Supported by the Public Although tobacco companies have suggested that pictorial warnings “harass” smokers, research suggests that, overall, smokers welcome more health information on their packages, including information that presents the health consequences of smoking in a vivid, arousing manner. Several studies also report high levels of public support for graphic pictorial warnings, including among a majority of smokers. |
Current International Best Practice
More than 30 countries have implemented pictorial warnings to date. Most of these countries require pictorials to appear on the front and back of packs, as per recommendations under the Guidelines.
Laws and Regulations
Brunei Tobacco (Labelling) Regulations 2007
Malaysia Control of Tobacco Product Regulations Amendment 2008
Singapore Control of Advertisement and Sale of Tobacco (Labelling) Regulation Amendments 2003
Singapore Labelling Regulation Amendment 2006 New Set of Pictorial Warnings
Thailand Ministry of Public Health Notification No.11 Cigarettes and Cigars Pictorial Warnings 2006
Thailand Ministry of Public Health Notification No.14 Displaying Pictorial Labels and Statements 2007
Thailand Ministry of Public Health Notification No.13 Cigars Pictorial Warnings 2007
Thailand Ministry of Public Health Notification 2009 Pictorial Warnings