Throughout my life I’ve had a few collections: polished rocks, beanie babies, stickers. Thanks to my cousins’ selection, I now, as an adult, have a burgeoning unicorn collection. But this year, during my International Public Health studies I’ve started a new, and admittedly, odd collection of (empty) cigarette boxes. This morning I found an empty package from China on the street and got a few “you’re crazy” looks when I excitedly picked it up and put it in my backpack. Hey — I own a fair number of Australian versions, but this is my first international package!
In recent years, the smoking rate has dropped to between 16-20% in Australia. Much of Australia’s recent success in decreasing smoking rates stems from the World Health Organization’s Framework Convention on Tobacco Control (FCTC), the first WHO international treaty. It was adopted by the World Health Assembly (the meeting of WHO Member States) in 2003 and came into force in 2005.
The FCTC includes provisions to limit lobbying interactions between lawmakers and the tobacco industry, increase taxes on tobacco products (one of the most effective measures to decrease tobacco consumption), limit exposure to passive smoking, increase public awareness of the health consequences of smoking, regulate the contents of tobacco products, ban tobacco advertising, and include health warning labels on tobacco products, among other targeted measures. The FCTC calls for at least 30% of package space to be dedicated to health warnings, but encourages countries to adopt more aggressive measures where 50% or more of the package is covered by a health warning. In Australia, graphic health warnings are mandated to cover at least 75% of the package. However, the FCTC is only binding for countries that have both signed and ratified the treaty, which is why we haven’t seen these changes in the United States. The US has signed the FCTC, but has not (and will not) ratify the treaty.
Australia was the first country to introduce plain packaging of tobacco products as part of aggressive government-supported measures to reduce the use of tobacco products. Plain packaging, also known as generic packaging, requires that all branding is removed from tobacco packaging and regulates the size, font, and placement of the tobacco manufacturer’s name. It also mandates that health warnings are prominently included on the package. Products must be sold in a uniform olive green package, the color determined through research to be “least attractive.”
Implementation of the legislation in Australia began on January 1, 2012, with all measures implemented by the end of the year. The evidence behind the policy shows that plain packaging will increase the salience of health warning messages, reduce misleading messages on tobacco product packages, and reduce the attractiveness of tobacco products for both adults and children.
While the FCTC regulation and Australia’s legislation has not been without legal challenges from the tobacco industry, plain packaging is a big step toward decreasing worldwide rates of smoking. Based on the success in Australia, countries such as Canada, European Union countries, the United Kingdom, France, Norway, India, Ireland and New Zealand are all considering adopting their own plain packaging measures. The United States is conspicuously absent from this this and inconspicuously influenced by the tobacco lobby to go soft on tobacco reduction measures. Knowing the indisputable negative health consequences of smoking, let’s work together to encourage the United States (and all countries worldwide) to take a strong stance to support their citizens’ health and to decrease tobacco use. Let’s put health interests ahead of industry interests.