The National Partnership Agreement on Preventive Health has set the aim of reducing the proportion of Australians who smoke daily to 10% by 2018. Graphic health warnings on tobacco product packaging are an important tool in the battle to reduce the health burden associated with smoking. At least 27 countries across the world have finalised requirements for graphic health warnings and a number of others have announced their intention or are undertaking the process to introduce them. Graphic health warnings have been required on almost all tobacco product packaging3 in Australia since 2006.

The Australian Competition and Consumer Commission (ACCC) administers the regulation of on-pack tobacco health warnings, while the Department of Health and Ageing (the Department) provides policy input. The warnings, messages and images are intended to:
    • increase consumer knowledge of the health effects of smoking;
    • encourage smokers to give up; and
    • discourage uptake or relapse.
In 2008 a comprehensive evaluation of the health warnings used in Australia was conducted. The evaluation consisted of a literature review, as well as qualitative and quantitative consumer research. This indicated that the introduction of graphic health warnings has been highly successful. Consumer knowledge of the health effects of smoking has increased and the warnings have both encouraged smokers to quit and discouraged smoking uptake and relapse.

On-pack visuals were found to have been particularly helpful in enhancing the impact of health warnings. Images were found to increase the noticeability of the messages and make them more difficult to ‘screen out’. Importantly many consumers felt that the graphic health warnings had helped to deglamourise smoking. Moreover, almost a quarter of smokers admitted to hiding or concealing their packs, indicating that the graphic warnings made them feel uncomfortable about their habit. Images alongside messages that generate an emotional response, such as ‘Don’t let children breathe your smoke’, have been found to be particularly effective. The explanatory text was also seen by some as credible and helps convey the potential health consequences of smoking.

However, areas for improvement were identified in the evaluation. In particular there was a decline in readership of the side of pack information that informs smokers about the chemicals in tobacco products and the chemicals released when they are smoked. There has also been a decline in readership of the front-ofpack warning, which currently only covers 30% of the front surface of packs. In addition, some consumers have problems with interpreting technical language in the health warning messages and some of the images were not felt to be clear, or their impact is declining. The need to ensure the Quitline number and statistics are up-to-date and accurate was also identified.

A great deal of research has been conducted internationally on graphic health warnings. In combination with the Australian research findings, the conclusions from international studies have helped to inform the redesign of potential new graphic health warnings in Australia.

3 Warnings are currently not required on tobacco for export or single sale cigars
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