Skip to main content
SpringerLink
Log in

Cigarette pack labelling in 12 countries at different levels of economic development

  • Original Article
  • Published:
Journal of Public Health Policy Aims and scope Submit manuscript

Abstract

With increasing restrictions on cigarette marketing, the cigarette pack itself has become a main means of marketing. We describe a method to examine cigarette labelling and use it to evaluate packs collected from 12 countries at different stages of economic development. Health warnings were present on all 115 packs of cigarettes examined, but were on the front and back panels of only 68 per cent. Promotional labels were widespread, found on packs from all countries and more numerous (although not necessarily larger) than health warning labels in 10 of the 12 countries. Deceptive terms such as ‘light’ and ‘mild’ were observed on 42 per cent of all packs examined. The simple method described here can be used to compare cigarette labelling and potentially evaluate and track the implementation of cigarette labelling policy. We found health warning legislation poorly enforced and cigarette packs widely used to promote smoking and deceive smokers about health risks. The findings underline the need for generic (plain) packaging.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1

Similar content being viewed by others

References

  • Beaglehole, R., Irwin, A., Prentice, T. and World Health Organization. (2003) The World Health Report. Shaping the Future. Geneva, Switzerland: World Health Organization.

    Google Scholar 

  • Article 11 Packaging and labelling of tobacco products: WHO Framework Convention on Tobacco Control (WHO FCTC) – The Treaty Text (2003) Geneva, Switzerland: Framework Convention Alliance.

  • Hammond, D., Fong, G.T., McDonald, P.W., Cameron, R. and Brown, K.S. (2003) Impact of the graphic Canadian warning labels on adult smoking behaviour. Tobacco Control 12 (4): 391–395.

    Article  Google Scholar 

  • Willemsen, M.C. (2005) The new EU cigarette health warnings benefit smokers who want to quit the habit: Results from the Dutch continuous survey of smoking habits. European Journal of Public Health 15 (4): 389–392.

    Article  Google Scholar 

  • Hamilton, W.L., Norton, G., Ouellette, T.K., Rhodes, W.M, Kling, R. and Connolly, G.N. (2004) Smokers’ responses to advertisements for regular and light cigarettes and potential reduced-exposure tobacco products. Nicotine & Tobacco Research 6 (3): S353–S362.

    Article  Google Scholar 

  • Etter, J.F., Kozlowski, L.T. and Perneger, T.V. (2003) What smokers believe about light and ultralight cigarettes. Preventive Medicine 36 (1): 92–98.

    Article  Google Scholar 

  • Hammond, D. and Parkinson, C. (2009) The impact of cigarette package design on perceptions of risk. Journal of Public Health (Oxf) 31 (3): 345–353.

    Article  Google Scholar 

  • Gendreau, P.L. and Vitaro, F. (2005) The unbearable lightness of ‘light’ cigarettes: A comparison of smoke yields in six varieties of Canadian ‘light’ cigarettes. Canadian Journal of Public Health 96 (3): 167–172.

    Google Scholar 

  • Kozlowski, L.T., Goldberg, M.E., Yost, B.A., White, E.L., Sweeney, C.T. and Pillitteri, J.L. (1998) Smokers’ misperceptions of light and ultra-light cigarettes may keep them smoking. American Journal of Preventive Medicine 15 (1): 9–16.

    Article  Google Scholar 

  • Hammond, D., Dockrell, M., Arnott, D., Lee, A. and McNeill, A. (2009) Cigarette pack design and perceptions of risk among UK adults and youth. European Journal of Public Health 19 (6): 631–637.

    Article  Google Scholar 

  • Fong, G.T. (2009) FCTC Article 11 Tobacco warning labels: Evidence and recommendations from the ITC Project. International Tobacco Control Policy Evaluation Project.

  • Moodie, C. and Hastings, G. (2010) Tobacco packaging as promotion. Tobacco Control 19 (2): 168–170.

    Article  Google Scholar 

  • Moodie, C. and Hastings, G.B. (2009) Making the pack the hero, tobacco industry response to marketing restrictions in the UK: Findings from a long-term audit. International Journal of Mental Health and Addiction 9 (1): 24–38.

    Article  Google Scholar 

  • Pierce, J.P. et al (2010) Camel No. 9 cigarette-marketing campaign targeted young teenage girls. Pediatrics 125 (4): 619–626.

    Article  Google Scholar 

  • Toll, B.A. and Ling, P.M. (2005) The Virginia Slims identity crisis: An inside look at tobacco industry marketing to women. Tobacco Control 14 (3): 172–180.

    Article  Google Scholar 

  • Teo, K., Chow, C.K., Vaz, M., Rangarajan, S. and Yusuf, S. (2009) The Prospective Urban Rural Epidemiology (PURE) study: Examining the impact of societal influences on chronic noncommunicable diseases in low-, middle-, and high-income countries. American Heart Journal 158 (1): 1–7.

    Article  Google Scholar 

  • Chow, C.K. et al (2010) Environmental Profile of a Community's Health (EPOCH): An instrument to measure environmental determinants of cardiovascular health in five countries. PLoS One 5 (12): e14294.

    Article  Google Scholar 

  • The World Bank. (2007) World development indicator database. World Bank List of Economies, July 2007 edn. Washington DC: The World Bank, p. 6.

  • Peace, J., Wilson, N., Hoek, J., Edwards, R. and Thomson, G. (2009) Survey of descriptors on cigarette packs: Still misleading consumers? New Zealand Medical Journal 122 (1303): 90–96.

    Google Scholar 

  • Wakefield, M. and Letcher, T. (2002) My pack is cuter than your pack. Tobacco Control 11 (2): 154–156.

    Article  Google Scholar 

  • World Health Organization. (2008) WHO Report on the Global Tobacco Epidemic. The MPOWER package. Geneva, Switzerland: World Health Organization.

  • Assunta, M. and Chapman, S. (2004) A mire of highly subjective and ineffective voluntary guidelines: Tobacco industry efforts to thwart tobacco control in Malaysia. Tobacco Control 13 (2): ii43–50.

    Google Scholar 

  • Cavalcante, TM. and World Health Organization. (2003) Labelling and Packaging in Brazil. Tobacco Control. WHO Tobacco Control Papers.

  • Shimkhada, R. and Peabody, J.W. (2003) Tobacco control in India. Bulletin of the World Health Organization 81 (1): 48–52.

    Google Scholar 

  • Pan American Health Organization. (1998) Prevention and Control of Tobacco Use. Washington DC: Pan American Health Organization, pp. 1–19.

  • Sebrie, E.M., Barnoya, J., Perez-Stable, E.J. and Glantz, S.A. (2005) Tobacco industry successfully prevented tobacco control legislation in Argentina. Tobacco Control 14 (5): e2.

    Article  Google Scholar 

  • Sussman, S. et al (2007) Tobacco control in developing countries: Tanzania, Nepal, China, and Thailand as examples. Nicotine & Tobacco Research 9 (Suppl 3): S447–S457.

    Article  Google Scholar 

  • Chaudhry, K. (2002) Tobacco control in India. In: S.P. Agarwal, Y.N. Rao and S. Gupta (eds.) Fifty Years of Tobacco Control in India: National Cancer Control Programme. New Delhi: Directorate General of Health Services, Government of India, pp. 196–211.

    Google Scholar 

  • Daly, J. (2008) Latin tobacco: Negative outlook. Latin Business Chronicle, Coral Gables, FL: Merit designs.

  • Physicians for a Smoke-Free Canada. (2008) http://www.smoke-free.ca/warnings, Ottawa, ON: Physicians for a Smoke-Free Canada.

  • Health Related Information Dissemination Amongst Youth (HRIDAY). (2008) Story of pictorial health warnings on tobacco product packages in India. Advocacy Forum for Tobacco Control (AFTC). New Delhi: Advocacy Forum for Tobacco Control (AFTC), pp. 1–5.

  • People's Daily Online. (2009) China's anti-tobacco fighters demand warning pictures on cigarettes. Xinhua News Agency.

  • World Health Organization. (2009) Updated status of the WHO FCTC: Ratification and accession by country. pp. 1–9.

  • Gilmore, A.B. and McKee, M. (2004) Moving east: How the transnational tobacco industry gained entry to the emerging markets of the former Soviet Union - part I: Establishing cigarette imports. Tobacco Control 13 (2): 143–150.

    Article  Google Scholar 

  • World Health Organization. (2001) Coveting Iran: The Infiltration and Exploitation of Iran by Global Cigarette Companies. Cairo, Egypt: WHO EMRO.

  • Shafey, O., Cokkinides, V., Cavalcante, T.M., Teixeira, M., Vianna, C. and Thun, M. (2002) Case studies in international tobacco surveillance: Cigarette smuggling in Brazil. Tobacco Control 11 (3): 215–219.

    Article  Google Scholar 

  • Chaudhry, S. and Chaudhry, K. (2007) Point of sale tobacco advertisements in India. Indian Journal of Cancer 44 (4): 131–136.

    Article  Google Scholar 

  • Wakefield, M.A., Germain, D. and Durkin, S.J. (2008) How does increasingly plainer cigarette packaging influence adult smokers’ perceptions about brand image? An experimental study. Tobacco Control 17 (6): 416–421.

    Article  Google Scholar 

  • Wakefield, M., Morley, C., Horan, J.K. and Cummings, K.M. (2002) The cigarette pack as image: New evidence from tobacco industry documents. Tobacco Control 11 (1): I73–80.

    Article  Google Scholar 

  • Jackson, M.C., Hastings, G., Wheeler, C., Eadie, D. and Mackintosh, A.M. (2000) Marketing alcohol to young people: Implications for industry regulation and research policy. Addiction 95 (4): S597–S608.

    Article  Google Scholar 

  • Wen, C.P. et al (2005) Are marketing campaigns in Taiwan by foreign tobacco companies targeting young smokers? Tobacco Control 14 (1): i38–i44.

    Article  Google Scholar 

  • Cunningham, R. and Kyle, K. (1995) The case for plain packaging. Tobacco Control 4: 80–86.

    Article  Google Scholar 

  • Freeman, B., Chapman, S. and Rimmer, M. (2008) The case for the plain packaging of tobacco products. Addiction 103 (4): 580–590.

    Article  Google Scholar 

  • Aftab, M., Kolben, D. and Lurie, P. (1999) International cigarette labelling practices. Tobacco Control 8 (4): 368–372.

    Article  Google Scholar 

  • Wilson, N. et al (2009) Distribution of new graphic warning labels: Are tobacco companies following regulations? Tobacco Induced Diseases 5 (1): 14.

    Article  Google Scholar 

Download references

Acknowledgements

We thank the Investigators of the PURE study.16 The teams lead by the following investigators contributed to the cigarette pack collection for this study: R. Diaz (Argentina), A. Avezum (Brazil), S Rangarajan (Canada), F Lanas (Chile), Li Wei (China), Mario Vaz (India), R. Kelishadi (Iran), R Iqbal (Pakistan), K. Yusoff (Malaysia), P. Lopez-Jaramillo (Colombia)

Author information

Authors and Affiliations

  1. Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada

    Hassan Mir, Daniel Buchanan, Salim Yusuf & Clara K Chow

  2. London School of Hygiene and Tropical Medicine, London, United Kingdom

    Anna Gilmore & Martin McKee

  3. Department for Health, University of Bath, Bath, United Kingdom

    Anna Gilmore

  4. The George Institute for Global Health, University of Sydney, Missenden Road, PO Box M201, Camperdown, 2050, NSW, Australia

    Clara K Chow

Authors
  1. Hassan Mir
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniel Buchanan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anna Gilmore
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Martin McKee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Salim Yusuf
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Clara K Chow
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Clara K Chow.

Additional information

†CKC had the original idea and supervised HM, who developed the data collection instrument, collected data and drafted the article; DB contributed to data collection and analysis; AG provided expertise in tobacco control and policy research, contributed to the labelling categorisation, analysis, and revisions of the manuscript; MM has expertise in policy research and commented on manuscripts; CKC checked data analysis, revised the article and is guarantor. AG, MM, SY, and CC participated in the EPOCH (Environmental Profile of a Community's Health) collaboration and PURE (Prospective Urban Rural Epidemiology) study. MM and SY both mentored CC in the EPOCH project, intellectually inputted into the study design and manuscript. All authors have given final approval for this article to be published.

To compare warnings and advertising on cigarette labels, the authors describe a method for evaluating information on the cigarette pack–itself a major marketing tool.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mir, H., Buchanan, D., Gilmore, A. et al. Cigarette pack labelling in 12 countries at different levels of economic development. J Public Health Pol 32, 146–164 (2011). https://doi.org/10.1057/jphp.2011.3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1057/jphp.2011.3

Keywords

Search

Navigation