Cigarette Package Health Warnings in Japan

Abstract

TPS 641: Policies, interventions, communication, Exhibition Hall, Ground floor, August 28, 2019, 3:00 PM - 4:30 PM [Aim] The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) requires member countries to implement measures aimed at reducing the demand for tobacco products. FCTC article 11 recommends on large and pictorial health warnings. In 2001 Canada firstly implemented pictorial warning. By the end of 2016, 100 countries/jurisdictions had implemented pictorial warnings, and the number increased to 118 now. On Dec 2018, the Japanese Finance Ministry drew up a plan to enlarge the font of text warnings on tobacco packages, while rejecting graphical warnings, arguing that consumers must not be made excessively uncomfortable. Then we conducted an online survey to measure the impact of the change in health warnings. [Methods] A cross-sectional online survey was conducted from 26 January to 20 March in 2018. Participants were randomly sampled from a nationwide online panel. The age-gender balanced 8,140 effective sample was obtained. The number of never smoker, former smoker, and current smoker is 4,605, 2,076, and 1,459, respectively. We prepared 5 health warning designs, which include current text alone warning covering 30% of the front/back of the package, larger text warnings, picture warnings covering 50% or 75% of the packages. We observed the participants’ recognition of the health warnings, and label ranking for smoking cessation. [Results] The percentage of persons who know pictorial health warnings is 32.6%, 25.4%, 32.3%, 44.2% for total responders, never smoker, former smoker, and current smoker, respectively. The 52.8%, 60.9%, 61.2%, and 34.1% of total responders, never smoker, former smoker, and current smoker, respectively, ranked the large pictorial health warnings as most effective. [Conclusions] Text-only warnings are the least effective way to increase public awareness about the risk of tobacco use. We should introduce picture warnings that have the potential to help them better understand the harms of tobacco and encourage smoking cessation.