Health Warnings and Pictures on Cigarette Packs as Deterrence to Smokers

Dr Janil Puthucheary asked the Minister for Health (a) to what extent are the health warnings and pictures on cigarette packs in Singapore effective in being a deterrent to smokers; and (b) whether the Ministry has done a survey to study whether it has any impact on smokers' minds or whether smokers have become desensitised to the images.

Er Dr Lee Bee Wah asked the Minister for Health (a) what is the Ministry's assessment of reports stating that the removal of displays of tobacco products can reduce the likelihood of young people buying them; and (b) whether the Ministry will introduce this ban on the display of tobacco products in retail outlets.

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Graphic health warnings are part of a comprehensive suite of tobacco control measures in Singapore that include public education campaigns, smoking cessation programmes, taxes and bans on advertising, sale to minors and smoking in public places.

The World Health Organization (WHO) recommends the use of graphic health warning labels on cigarette packages as it is more effective than text-only labels. In 2005, the Health Promotion Board (HPB) evaluated the impact of the introduction of graphic health warning labels and found that seven in 10 (71%) smokers said they knew more about the health effects of smoking, and more than 50% of the smokers were more concerned about their health after seeing the graphic health warnings. 25% of smokers were motivated to quit as a result and made efforts to abstain from smoking. The effect on non-smokers was equally significant; more than half of them advised their friends and loved ones to quit smoking as a result of seeing the graphic health warnings.

To prevent desensitisation, as Dr Janil Puthucheary has pointed out, graphic health warnings are changed every few years to ensure they remain effective. This year, we introduced a ban on misleading descriptors, and added new text warnings.1

Besides the enhanced use of graphic health warnings on tobacco packaging, my Ministry is also concerned with the prominent displays of tobacco products functioning as a form of advertisement for smoking.

Research studies have shown that the Point-of-Sale display (POSD) of tobacco products is not only attractive but also influences purchasing behaviours. In Canada, Iceland and Ireland, implementation of a POSD ban was associated with a decrease in smoking. POSD bans, as implemented overseas, are aimed at decreasing exposure of non-smokers, in particular, vulnerable populations, such as youths, to the advertising effect of POSD; and it is another means of denormalising the use of tobacco products. This, together with other tobacco control measures that are already in place, will potentially lead to a decrease in smoking initiation rates. In addition, it would help to reduce impulse purchases among smokers who are trying to quit.

The public consultation on the POSD ban was completed on 30 June 2013. HPB and HSA also conducted trade engagement sessions with retailers and associations in July 2013. We are studying the results of the consultation and more details will be shared in due course.

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