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Tobacco packaging warning messages

Tobacco package warning messages are warning messages that appear on the packaging of cigarettes and other tobacco products concerning their health effects. They have been implemented in an effort to enhance the public's awareness of the harmful effects of smoking. In general, warnings used in different countries try to emphasize the same messages. Warnings for some countries are listed below. Such warnings have been required in tobacco advertising for many years, with the earliest mandatory warning labels implemented in the United States in 1966.[1] Implementing tobacco warning labels has been strongly opposed by the tobacco industry, most notably in Australia, following the implementation of plain packaging laws.

The WHO Framework Convention on Tobacco Control, adopted in 2003, requires such warning messages to promote awareness against smoking.[2]

A 2009 review summarises that there is "clear evidence that tobacco package health warnings increase consumers' knowledge about the health consequences of tobacco use". The warning messages "contribute to changing consumers' attitudes towards tobacco use as well as changing consumers' behaviour".[3]

At the same time, such warning labels have been subject to criticism.[4][5] 2007 meta-analyses indicated that communications emphasizing the severity of a threat are less effective than communications focusing on susceptibility[6] and that warning labels may have no effect among smokers who are not confident that they can quit, which lead the authors to recommend exploring different, potentially more effective methods of behaviour change.[7]

In many countries, a variety of warnings with graphic, disturbing images of tobacco-related harms (including hematuria and diabetes) are placed prominently on cigarette packages.

Albania

Text-based warnings on cigarette packets are used in Albania. General warning:

Other warnings used are:

Argentina

General warning (former):

As of 30 January 2013, all cigarette packages must include graphical warning labels that show the detrimental effects on the health of long-term smokers, including COVID-19 (added in 2022).[8][9][10]

Australia

On 1 December 2012, Australia introduced ground-breaking legislation and the world's toughest tobacco packaging warning messages to date.[11] All marketing and brand devices were removed from the package and replaced with warnings, only the name of the product remains in generic standard sized text. All tobacco products sold, offered for sale or otherwise supplied in Australia were plain-packaged and labelled with new and expanded health warnings.[12][13]

Azerbaijan

In Azerbaijan, cigarette packages carry a small notice: "Ministry of Health warns: Smoking is dangerous for your health", with no mandate on a minimum required size of the warning and a typical warning occupying around 6% of each side of the packaging. A specific health warning, as in a detailed description of the health effects of smoking and variety in the warnings used are not required by Azerbaijani law alongside no mandate for imagery.[14]

Bangladesh

50% of pictorial health warnings are implemented on the packets of all tobacco products in Bangladesh from 19 March 2016.

Bolivia

In Bolivia, a variety of warnings with graphic, disturbing images of tobacco-related harms (including laryngeal cancer and heart attack) are placed prominently on cigarette packages.

Bosnia and Herzegovina

Front of packaging (covers 30% of surface):

Back of packaging (covers 50% of surface):

Before 2011, a small warning with the text Pušenje je štetno za zdravlje (Smoking is harmful to health) was printed on the back of cigarette packets.

Brazil

Brazil's third batch of graphic images (since replaced), mandatory on all cigarette packs

In 2001, Brazil became the second country in the world and the first country in Latin America to adopt mandatory warning images in cigarette packages.[15] Warnings and graphic images illustrating the risks of smoking occupy 100% of the back of cigarette packs. In 2008, the government enacted a third batch of images[16] aimed at younger smokers.[15] The rule was in force for nine years until 2017, when yet another batch of warnings were introduced. They contain images as equally disturbing as the previous ones but also contain subtle messages such as "Você morre" (You die), "Você sofre" (You suffer) and "Você adoece" (You get sick).

Since 2003, the sentence

Este produto contém mais de 4,7 mil substâncias tóxicas, e nicotina que causa dependência física ou psíquica. Não existem níveis seguros para consumo dessas substâncias. (This product contains over 4,700 toxic substances and nicotine, which causes physical or psychological addiction. There are no safe levels for consuming these substances.)

is displayed in all packs.

Brunei

The following warnings appear on Bruneian cigarette packages since 2007:[17][18][19]

Cambodia

In Cambodia, a variety of warnings with graphic, disturbing images of tobacco-related harms (including premature birth and lung cancer) are placed prominently on cigarette packages.

Canada

Canada has had three phases of tobacco warning labels. The first set of warnings was introduced in 1989 under the Tobacco Products Control Act, and required warnings to be printed on all tobacco products sold legally in Canada. The set consisted of four messages printed in black-and-white on the front and back of the package, and was expanded in 1994 to include eight messages covering 25% of the front top of the package.[20] In 2000, the Tobacco Products Information Regulations (TPIR) were passed under the Tobacco Act. The regulations introduced a new set of sixteen warnings. Each warning was printed on the front and back of the package, covering 50% of the surface, with a short explanation and a picture illustrating that particular warning, for example:

CIGARETTES CAUSE LUNG CANCER
85% of lung cancers are caused by smoking.
80% of lung cancer victims die within three years.

accompanied by a picture of cancerous growths inside a human lung.

Additionally, on the inside of the packaging or, for some packets, on a pull-out card, "health information messages" provide answers and explanations regarding common questions and concerns about quitting smoking and smoking-related illnesses. The side of the package also featured information on toxic emissions and constituent levels.[21]

In 2011, the TPIR were replaced for cigarettes and little cigars with the Tobacco Products Labelling Regulations (Cigarettes and Little Cigars). These regulations introduced the third and current set of 16 warnings in Canada. Currently, cigarette and little cigar packages in Canada must bear new graphic warning messages that cover 75% of the front and back of the package. The interior of each package contains 1 of 8 updated health warning messages, all including the number for a national quitline. The side of the package now bears 1 of 4 simplified toxic emission statements. These labels were fully implemented on cigarette and little cigar packages by June 2012 (though the 2000 labels still appear on other tobacco products). Canada also prohibits terms such as "light" and "mild" from appearing on tobacco packaging.[21] The current labels were based on extensive research and a long consultation process that sought to evaluate and improve upon the warnings introduced in 2000.[22]

In accordance with Canadian law regarding products sold legally in Canada, the warnings are provided in both English and French. Imported cigarettes to be sold in Canada which do not have the warnings are affixed with sticker versions when they are sold legally in Canada.

Health Canada considered laws mandating plain packaging, legal tobacco product packaging did still include warning labels, but brand names, fonts, and colors were replaced with simple unadorned text, thereby reducing the impact of tobacco industry marketing techniques.[23]

There have been complaints from some Canadians due to the graphic nature of the labels.[who?] It was mandated in January 2020.

Canada became the first country in the world to require health warnings on each individual cigarettes and cigars, effective August 1, 2023, to be phased in over time when the regulation is fully in effect by April 2025.[24]

Chile

Starting in November 2006, all cigarette packages sold in Chile are required to have one of two health warnings, a graphic pictorial warning or a text-only warning. These warnings are replaced with a new set of two warnings each year.[25]

China

Under laws of the People's Republic of China, the Law on Tobacco Monopoly (中华人民共和国烟草专卖法) Chapter 4, Article 18 and Regulations for the Implementation of the Law on Tobacco Monopoly (中华人民共和国烟草专卖法实施条例) Chapter 5 Article 29, cigarettes and cigars sold within Mainland China should indicate the grade of tar content and "Smoking is hazardous to your health" (吸烟有害健康) in the Chinese language on the packs and cartons.

In 2009, the warnings were changed. The warnings, which occupy not less than 30% of the front and back of cigarette packs, show "吸烟有害健康 尽早戒烟有益健康" (Smoking is harmful to your health. Quitting smoking early is good for your health) in the front and "吸烟有害健康 戒烟可减少对健康的危害" (Smoking is harmful to your health. Quitting smoking can reduce health risks) in the back.

The warnings were revised in October 2016 and must occupy at least 35% of the front and back of cigarette packs. The following are the current warnings.

Colombia

In Colombia, a variety of warnings with graphic, disturbing images of tobacco-related harms (including clogged arteries and bladder cancer) are placed prominently on cigarette packages.

Costa Rica

In Costa Rica, a variety of warnings with graphic, disturbing images of tobacco-related harms (including lung cancer and heart attack) are placed prominently on cigarette packages.

East Timor

East Timor only used a text warning, "FUMA OHO ITA" (Smoking kills), prior to 2018, when new pictorial warnings covering 85% of the front and 100% of the back of packages were implemented.[26][27][28]

The warnings currently in use are:

Ecuador

In Ecuador, a variety of warnings with graphic, disturbing images of tobacco-related harms (including tongue cancer and premature birth) are placed prominently on cigarette packages.

Egypt

In Egypt, a variety of warnings with graphic, disturbing images of tobacco-related harms (including mouth cancer and gangrene) are placed prominently on cigarette packages.

European Union

Cigarette packets and other tobacco packaging must include warnings in the same size and format and using the same approved texts (in the appropriate local languages) in all member states of the European Union.

These warnings are displayed in black Helvetica bold on a white background with a thick black border. Ireland once prefaced its warnings with "Irish Government Warning", Latvia with "Veselības ministrija brīdina" (Health Ministry Warning) and Spain with "Las autoridades sanitarias advierten" ("The Health Board Warns"). In member states with more than one official language, the warnings are displayed in all official languages, with the sizes adjusted accordingly (for example in Belgium the messages are written in Dutch, French and German, in Luxembourg in French and German and in Ireland, in Irish and English). All cigarette packets sold in the European Union used to have to display the content of nicotine, tar, and carbon monoxide in the same manner on the side of the packet, this is no longer the case.

In 2003, it was reported that sales of cigarette cases had surged, attributable to the introduction of more prominent warning labels on cigarette packs by an EU directive in January 2003.[29] Alternatively, people choose to hide the warnings using various "funny" stickers, such as "You could be hit by a bus tomorrow."[29]

The most recent EU legislation is the Tobacco Products Directive, which became applicable in EU countries in May 2016.[30]

Austria and Germany

Carton of German cigarettes, complete with warning
General warnings
Additional warnings

Belgium

In Belgium, warning signs are written in Dutch, French and German, the three official languages of Belgium.

Croatia

Front of packaging (covers 30% of surface):

or

Back of packaging (covers 40% of surface):

The last warning contains a mistranslation from Directive 2001/37/EC – "hydrogen" was translated as ugljik (carbon) instead of vodik. It was nevertheless signed into law and started appearing on cigarette packages in March 2009.

Front of packaging 2004–2009
Back of packaging 2004–2009
Side of packaging 2004–2009

2004–2009These warnings were also simple text warnings.

Front of packaging:

Back of packaging:

Side of packaging:

1997–2004Between 1997 and 2004, a simple text label warning, Pušenje je štetno za zdravlje (Smoking is harmful to health), was used.

Cyprus

Front side

or

Rear

Czech Republic

As of 7 December 2016, all packages must also include warning images additionally to text warnings. Also cigarette manufacturers are prohibited to display the content of nicotine, tar and carbon monoxide on cigarette packages, because it might mislead customers. The box previously containing the contents of the cigarette was replaced by a warning message: Tabákový kouř obsahuje přes 70 látek, které prokazatelně způsobují rakovinu. (Tobacco smoke contains over 70 substances, which provably cause cancer.)[30][31][32]

Denmark

Warning texts in tobacco products, health warnings, which are reproduced on the packaging of cigarettes and other tobacco products. It is implemented in an effort to strengthen public knowledge about the dangers of smoking.

The order was introduced in Denmark on 31 December 1991. The Order was last revised on 2 October 2003, which also imposed ban on the words "light" and "mild" on Danish cigarette packages, as did European Union countries.

The marking shall appear on one third of the most visible part of the package.

For smokeless tobacco use above markings does not, whereas the label "Denne tobaksvare kan være sundhedsskadelig og er afhængighedsskabende" (This tobacco product can damage your health and is addictive) is always used for such products.

Estonia

General warning:

or

Finland

On the left there is a new Lucky Strike cigarette pack by a new EU directive meanwhile on the right there's an obsolete pack as red. The warning texts are both in Finnish and Swedish as they both are official languages in Finland.

In Finland, warning signs are written in both Finnish and Swedish languages.

France

Warning on a French cigarette pack

Before January 2017, France used regular EU warnings for tobacco products.

Front of packaging (covers 30% of surface)

or

Rear (covers 40% of surface, similar design)
Left or right side of packaging
Other side of packaging
Other characteristics

Plain packaging has been regulated since January 2017.

Greece

Hungary

Ireland

Packet of Irish cigarettes, complete with warning

Ireland currently follows EU standards (see above), but previously ran its own scheme, where one of 8 messages was placed on the pack, as defined in SI 326/1991.[33]

After a High Court settlement in January 2008, it was accepted that the warnings on tobacco products must appear in both official languages of the state.[34] As a result, the European Communities (Manufacture, Presentation and Sale of Tobacco Products) (Amendment) Regulations 2008 were put in place.[35] This provides that tobacco products going to market after 30 September 2008 must carry warnings in Irish and English. A year-long transition period applied to products which were on the market prior to 1 October 2008, which may have been sold until 1 October 2009.

Each packet of tobacco products must carry:

Italy

Other text is sometimes placed in the packets; for example, some packets contain leaflets which have all the above warnings written on them, with more detailed explanations and reasons to give up, and advice from Philip Morris.

Latvia

Lithuania

General warning:

or

Malta

Netherlands

Warning labels on cigarette packs in St. Maarten, the Dutch West Indies (February 2019)

Poland

Front of packaging (covers 30% of surface):

or

There are also warnings on the back of every packet:

Portugal

A warning message on a Portuguese pack of Lucky Strike

Romania

General warning (on the front of cigarette packages, covering at least 40% of the area):

Additional warnings (on the back of cigarette packages, covering at least 50% of the area):

Slovenia

Front of packaging (covers 30% of surface)

or

Rear of packaging (covers 40% of surface)

Spain

In Spain, cigarette packages are preceded by warnings on both sides of the package marked "Las Autoridades Sanitarias advierten" (Health authorities warn), written in black and white above the black part of the standard warning.

or

Front of cigarette packages
Back of cigarette packages

Sweden

A warning message on a Swedish pack of Level

General warnings on all Swedish cigarette packagings have been in force since 1977.

Front of cigarette packages
Back of cigarette packages
Rear side of snus packaging

Georgia

General warning:

Ghana

Ghanaian warnings are compliant with the EU's legislations, as follows:

Packaging 1 (same as in the newer UK packaging):

Packaging 2 (same as in the older UK packaging):

Packaging 3 (same as in the older UK packaging):

Honduras

In Honduras, a variety of warnings with graphic, disturbing images of tobacco-related harms (including a lung cancer and throat cancer) are placed prominently on cigarette packages.

Hong Kong

Under Hong Kong Law, Chap 371B Smoking (Public Health) (Notices) Order, packaging must indicate the amount of nicotine and tar that is present in cigarette boxes in addition to graphics depicting different health problems caused by smoking in the size and ratio as prescribed by law. The warnings are to be published in both official languages, Traditional Chinese and English.

Every warning begins with the phrase '香港特區政府忠告市民/HKSAR GOVERNMENT WARNING' and then one of the following in all caps:

In addition, any print advertisement must give minimum 85% coverage of the following warnings:

HKSAR GOVERNMENT HEALTH WARNING

In 2018, a new batch of warnings were introduced, consisting of the following warnings that cover 85% of packs:

Iceland

All cigarette packets and other tobacco packaging in Iceland must include warnings in the same size and format as in the European Union and using the same approved texts in Icelandic.

General warning:

These warnings are also used:

India

Cigarette packets sold in India are required to carry graphical and textual health warnings. The warning must cover at least 85% of the surface of the pack, of which 60% must be pictorial and the remaining 25% contains textual warnings in English, Hindi or any other Indian language.

In 2003, India ratified the World Health Organisation's Framework Convention on Tobacco Control, which includes a recommendation for large, clear health warnings on tobacco packages. However, there was a delay in implementing graphic warning labels.[36]

Until 2008,[37] cigarette packets sold in India were required to carry a written warning on the front of the packet with the text CIGARETTE SMOKING IS INJURIOUS TO HEALTH in English. Paan, gutkha and tobacco packets carried the warning TOBACCO IS INJURIOUS TO HEALTH in Hindi and English. The law later changed. According to the new law, cigarette packets were required to carry pictorial warnings of a skull or scorpion along with the text SMOKING KILLS and TOBACCO CAUSES MOUTH CANCER in both Hindi and English.

The Cigarette and Other Tobacco Products (Packaging and Labelling) Rules 2008 requiring graphic health warnings came into force on 31 May 2008. Under the law, all tobacco products were required to display graphic pictures, such as pictures of diseased lungs, and the text SMOKING KILLS or TOBACCO KILLS in English, covering at least 40% of the front of the pack, and retailers must display the cigarette packs in such a way that the pictures on pack are clearly visible. In January 2012, controversy arose when it was discovered that an image of former English footballer John Terry was used on a warning label.[38]

On 15 October 2014, Union Health Minister Harsh Vardhan announced that only 15% of the surface of a pack of cigarettes could contain branding, and that the rest must be used for graphic and text health warnings.[39] The Union Ministry of Health amended the Cigarettes and Other Tobacco Products (Packaging and Labelling) Rules, 2008 to enforce the changes effective from 1 April 2015.[37][40][41]

However, the government decision to increase pictorial warnings on tobacco packets from 1 April was put on hold indefinitely, following the recommendations of a Parliamentary committee, which reportedly did not speak to health experts but only to tobacco lobby representatives.[42] On 5 April 2016, the health ministry ordered government agencies to enforce this new rule.[43]

Following the intervention by the Parliamentary committee, NGO Health of Millions, represented by Prashant Bhushan, filed a petition in the Supreme Court of India, which asked the government to stop selling of loose cigarettes and publish bigger health warnings on tobacco packs.[44]

Indonesia

In Indonesia, tobacco warnings are not just placed on packages but also on cigarette advertisements, which are not banned in some countries including Indonesia.

January 1980-December 1999

January 2000-December 2013

With the enforcement of Indonesian Government Regulation No. 19 (2000), a new warning was implemented:

The last recorded usage of this warning in TV advertisements was an Esse Mild advertisement from late February 2014.[45]

December 2013–December 2018

The general warning used until 2018

With the enforcement of the Indonesian Government Regulation No. 109 (2012), all tobacco products/cigarette packaging and advertisement should include warning images and age restriction (18+). Graphic warnings must cover 40% of cigarette packages. After the introduction of graphic images in Indonesian cigarette packaging, the branding of cigarettes as "light", "mild", "filter", etc. is forbidden, except for brands that already use some words above such as L.A. Lights, A Mild or Dunhill Filter. However, the last advertisement to use this warning was a 2021 Djarum Super advertisement, before it subsequently used the 2018 warning.[46]

Other alternatives:

These warnings below appear on the side of cigarette packaging:

January 2019–

The general warning used since 2018

After it was revealed that the pictorial warnings used in Indonesia originally came from the 2005 warnings of Thailand,[48] on 31 May 2018, the Ministry of Health launched new pictorial health warnings, of which two depict Indonesian smokers and one depicts a smoker from Venezuela.[49][50]

Other alternatives:

Iran

In Iran, a variety of warnings with graphic, disturbing images of tobacco-related harms (including lung cancer and mouth cancer) are placed prominently on cigarette packages.

Japan

A cigarette package in Japan with a warning message

In 1972, Japan became the first country in Asia to display a general warning on cigarette packages.

Prior to 2005, there was only one warning on all Japanese cigarette packages.

Since 2005, more than one general warning is printed on cigarette packaging.

On the front of cigarette packages:

On the back of cigarette packages:

Laos

In Laos, a variety of warnings with graphic, disturbing images of tobacco-related harms (including mouth cancer and rotting teeth) are placed prominently on cigarette packages.

Malaysia

In Malaysia, general warning as a mandatory on all Malaysian cigarette packaging are in force since June 1976.[51]

Starting 1 June 2009, the Malaysian government has decided to place graphic images on the cigarette packs to show the adverse long-term effects of excessive smoking, replacing the general warning with text describing the graphic images printed in Malay (front) and English (back) explaining:

Graphic warning messages must consist 40% of the front of cigarette packages and 60% in the back. After the introduction of graphic images in Malaysian cigarette packaging, the branding of cigarettes as "light", "mild", etc. is forbidden.

Maldives

In the Maldives, products containing tobacco are required by law to have (in Dhivehi):[52]

At the front and back:

On the sides:

Mexico

Since 2010, cigarette packs in Mexico must contain health warnings and graphic images. By law, 30% of the pack's front, 100% of the pack's rear and 100% of one lateral must consist on images and warnings. The Secretariat of Health issues new warnings and images every six months. Images have included a dead rat, a partial mastectomy, a laryngectomy, a dead human fetus surrounded by cigarette butts, a woman being fed after suffering a stroke and damaged lungs, amongst others.

Warnings include smoking-related diseases and statistics, toxins found in cigarettes and others.

Mexico became the first country to put a warning on cigarette packs that tobacco use could increase the risk of COVID-19 infection.[53]

Moldova

General warning (on the front of cigarette packages, covering at least 30% of the area, Helvetica font):

Additional warnings (on the back of cigarette packages, covering at least 40% of the area, Helvetica font):

Regulated by "Lege cu privire la tutun şi la articolele din tutun" (Law on tobacco and tobacco articles) nr. 278-XVI from 14.12.2007[54] enabled at 07.03.2008

There is no such rule in Transnistria, where cigarette packages have variable warning labels depending on where they come from.

New Zealand

The first health warnings appeared on cigarette packets in New Zealand in 1974. Warning images accompanying text have been required to appear on each packet since 28 February 2008. New regulations were made on 14 March 2018 which provided for larger warnings and a new schedule of images and messages.[55]

By law,[55] 75% of a pack's front and 100% of its rear must consist of warning messages. Images include gangrenous toes, rotting teeth and gums, diseased lungs and smoking-damaged hearts. Cigarette packets also carry the New Zealand Quitline logo and phone number and other information about quitting smoking.[56]

In total, there are 15 different warnings. A full list with pictures is available at the New Zealand Ministry of Health's website. Warning messages are rotated annually. The following is a list of the warnings in English and Māori.

Smoking causes heart attacks, KA PĀ MAI NGĀ MANAWA-HĒ I TE KAI PAIPA

Smoking causes over 80% of lung cancers, NEKE ATU I TE 80% O NGĀ MATE PUKUPUKU KI NGĀ PŪKAHUKAHU I AHU MAI I TE KAI PAIPA

Smoking harms your baby before it is born, KA TŪKINOHIA TŌ PĒPI I TO KŌPŪ I TE KAI PAIPA

Your smoking harms others, KA TŪKINOHIA ĒTAHI ATU I Ō MAHI KAI PAIPA

Smoking is a major cause of stroke, KA PIKI AKE I TE KAI PAIPA TŌ TŪPONO KI TE IKURA RORO

Smoking damages your blood vessels, KA TŪKINOHIA Ō IA TOTO I TE KAI PAIPA

Smoking is not attractive, KA ANUANU KOE I TE KAI PAIPA

Smoking causes lung cancer, KA PĀ MAI TE MATE PUKUPUKU KI NGĀ PŪKAHUKAHU I TE KAI PAIPA

Smoking when pregnant harms your baby, KA TŪKINOHIA TŌ PĒPI I TE KAI PAIPA I A KOE E HAPŪ ANA

Your smoking harms children, KA TŪKINOHIA NGĀ TAMARIKI I Ō MAHI KAI PAIPA

Quit before it is too late, ME WHAKAMUTU KEI RIRO KOE

Smoking causes gum disease and stinking breath, KA PĀ TE MATE PŪNIHO, KA HAUNGA TŌ HĀ I TE KAI PAIPA

Nigeria

Six warnings existed prior to 2013:

From 2013 onwards, the general warning is: The Federal Ministry of Health warns that smokers are liable to die young.

North Korea

North Korea signed the WHO Framework Convention on Tobacco Control on 17 June 2003 and ratified it on 27 April 2005.[57] Tobacco packaging warning messages are required on all types of packaging, but their appearance is not regulated in any way.[58] They are usually printed in small print on the side of the package and only state that smoking is harmful to health.[59] However, the descriptions must state the nicotine and tar content,[60] must not be misleading and do need to be approved by local authorities.[61] Graphic warning images that are now common worldwide have never appeared on packaging in North Korea.[62]

Norway

A warning in Norwegian (bokmål)

Norway has had general warnings on cigarette packets since 1975. Norway's warnings of today were introduced in 2003 and are in line with the European Union's legislation, as Norway is an EEA member:

On the front of cigarette and cigar packages, covering about 30% of the area:

On the back of cigarette and cigar packages, covering about 45% of the area:

Tobacco products like snus and chewing tobacco have the following warning printed on them:

Pakistan

All cigarettes are required by Statutory Order 1219(I)/2008 dated 25 September 2008, published in the Gazette of Pakistan dated 24 November 2008, to carry rotating health warnings from 1 July 2009.

Each health warning is printed for a period of 6 months, covering at least 30% on both sides of the packet and must be printed in Urdu at the front and English at the back. The warnings in English currently in use are:

Panama

In Panama, a variety of warnings with graphic, disturbing images of tobacco-related harms (including throat cancer and lung cancer) are placed prominently on cigarette packages.

Paraguay

In Paraguay, a variety of warnings with graphic, disturbing images of tobacco-related harms (including impotence and heart attack) are placed prominently on cigarette packages.

Peru

In Peru, a variety of warnings with graphic, disturbing images of tobacco-related harms (including abortions and asthma) are placed prominently on cigarette packages.

Philippines

Tobacco packaging warning messages on cigarette packs sold in the Philippines prior to March 2016
Graphic warnings from 2016 to 2018
A new warning

All cigarette packaging sold in the Philippines are required to display a government warning label. The warnings include:

In July 2014, President Benigno Aquino III signed the Republic Act 10643, or "An Act to Effectively Instill Health Consciousness through Graphic Health Warnings on Tobacco Products", more known as the "Graphic Health Warning Act." This law requires tobacco product packaging to display pictures of the ill effects of smoking, occupying the bottom half of the display area in both front and the back side of the packaging.[63] On 3 March 2016, Department of Health (DOH) secretary Janette Garin started the implementation of Republic Act 10643, requiring tobacco manufacturers to include graphic health warnings on newer cigarette packaging.[64]

With the Graphic Health Warning Act implemented, graphic health warnings are used on all newer cigarette packages and older packages using text-only warnings are required to be replaced by newer ones incorporating graphic warnings.[65] The 12 new warnings, showing photos of negative effects of smoking, like mouth cancer, impotence and gangrene are rotated every month, and on 3 November 2016, all cigarette packaging without graphic health warning messages are banned from sale.[65] Labeling of cigarettes with "light" or "mild" is also forbidden by the Graphic Health Warning Act.[66]

Russia

Warning messages on Russian cigarette packets were revised in 2013, falling in line with European Union standards.

12 different variants are used.[67]

Serbia

A Serbian cigarette pack with a warning

The warning messages on Serbian cigarette packets are visually similar to what is used in European Union countries, but the texts used in Serbia are not translated from EU-approved texts.

Singapore

Singapore used blunt, straight-to-the-point messages such as "Smoking causes lung cancer" as text warnings on cigarette packets. They were later replaced by graphic warnings in August 2004, with gory pictures and the following messages:

In 2016, the images and warnings were revised, with images focusing mostly on damaged organs. The following warnings show what is printed nowadays.

From 1 January 2009, people possessing cigarettes without the SDPC (Singapore Duty Paid Cigarettes) label will be committing an offence under the Customs and GST Acts. The law was passed to distinguish non-duty paid, contraband cigarettes from duty-paid ones.

Switzerland

Switzerland has four official languages, but only has warning messages in three languages. The fourth language, Romansh, is only spoken by 0.5% of the population and those persons typically also speak either German or Italian. The three warning messages below, all meaning "Smoking kills", are posted on cigarette packs, cartons and advertisements such as outdoor billboards and posters:

Somalia

A small warning, in Somali and English, is printed on Somali cigarette packages.

South Africa

In South Africa, the Tobacco Products Control Act, 1993 and its amendments (1999, 2007, 2009), stipulate that a warning related to the harmful effects (health, social, or economic) of tobacco smoking, or the beneficial effects of cessation, must be placed prominently on tobacco products covering 15% of the obverse, 25% of the reverse and 20% of the sides of packs.[68][69]

According to the draft Control of Tobacco Products and Electronic Delivery Systems Bill, 2018, new legislation, once enacted, will require uniform, plain-colored packaging (branding and logos prohibited) containing the brand and product name in a standard typeface and color, a warning related to the harmful effects of tobacco smoking, or beneficial effects of cessation, and a graphic image of tobacco-related harm.[70]

South Korea

In South Korea, general warnings on cigarette packaging have been used since 1976. The warning messages used since then have been:

Front: 흡연은 폐암 등 각종 질병의 원인이 되며, 특히 임신부와 청소년의 건강에 해롭습니다 (Smoking causes lung cancer and other diseases and it is especially dangerous for teenagers and pregnant women)

Back: 19세 미만 청소년에게 판매할 수 없습니다 (It is illegal to sell cigarettes to people under 19) and additionally, 금연하면 건강해지고 장수할 수 있습니다 (You can be healthy and live longer if you quit), 흡연은 중풍과 심장병도 일으킵니다 (Smoking also causes paralysis and heart diseases), 흡연은 사랑하는 자녀의 건강도 해칩니다 (Smoking also damages your beloved children), 당신이 흡연하면 다른 사람의 건강도 해칩니다 (Smoking damages others)

Front: 건강을 해치는 담배 그래도 피우시겠습니까? (Smoking damages your health. Do you still want to smoke?)

Back: 19세 미만 청소년에게 판매할 수 없습니다 (It is illegal to sell cigarettes to people under 19) and additionally, 금연하면 건강해지고 장수할 수 있습니다 (You can be healthy and live longer if you quit), 흡연은 중풍과 심장병도 일으킵니다 (Smoking also causes paralysis and heart diseases), 흡연은 사랑하는 자녀의 건강도 해칩니다 (Smoking also damages your beloved children), 당신이 흡연하면 다른 사람의 건강도 해칩니다 (Smoking hurts others)

Front, 흡연은 폐암 등 각종 질병의 원인이 되며, 특히 임신부와 청소년의 건강에 해롭습니다 (Smoking causes lung cancer and other diseases and it is especially dangerous for teenagers and pregnant women)

Back: 19세 미만 청소년에게 판매 금지! 당신 자녀의 건강을 해칩니다" (It is illegal to sell cigarettes to people under 19! It hurts your children's health)

Front: 건강에 해로운 담배, 일단 흡연하게 되면 끊기가 매우 어렵습니다 (Smoking damages your health. Once you start smoking, it is very difficult to quit)

Back: 19세 미만 청소년에게 판매 금지! 당신 자녀의 건강을 해칩니다 (It is illegal to sell cigarettes to people under 19! It hurts your children's health)

Sri Lanka

In Sri Lanka, a variety of warnings with graphic, disturbing images of tobacco-related harms (including cancer and heart attack) are placed prominently on cigarette packages.

Taiwan

The warnings in Taiwan are led by the phrase "行政院衛生署警告" (Warning from the Department of Health, Executive Yuan:) and followed by one of the following warnings:

The images and warnings were revised in 2014, after the Department of Health was reorganised into the Ministry of Health and Welfare. The following warnings show what is printed since 1 June 2014.[73]

Warnings of any version are accompanied with "戒煙專線: 0800-636363" (Smoking Quitline: 0800–636363).

Thailand

In Thailand, a variety of warnings with graphic, disturbing images of tobacco-related harms (including a tracheotomy and rotting teeth) are placed prominently on cigarette packages.[74] A recent study showed that the warnings made Thai smokers think more often about the health risks of smoking and about quitting smoking.

Thailand introduced plain packaging in 2020.[75]

Turkey

A Turkish Viceroy pack with an old warning
Front of packaging (covers 65% of surface)

or

Back of packaging (covers 40% of surface)

Ukraine

The warning messages on Ukrainian cigarette packets are also visually similar to those in European Union countries:

United Kingdom

A Benson & Hedges pack in the United Kingdom, before the introduction of plain packaging in 2017

In 1971, tobacco companies printed on the left side of cigarette packets an official warning: "Warning by H.M. Government – Smoking can harm your health", followed by the phrase "Health Department's Chief Medical Officers", issuers of the warning.

In 1991, the EU tightened laws on tobacco warnings. Thus, the message "Tobacco seriously damages health" was printed on the front of all tobacco packs. An additional warning was also printed on the reverse of cigarette packs.

In 2003, new EU regulations required one of the following general warnings must be displayed, covering at least 30% of the surface of the pack:

Additionally, one of the following additional warnings must be displayed, covering at least 40% of the surface of the pack:

From October 2008, all cigarette products manufactured must carry picture warnings in the reverse. Every pack must have one of these warnings by October 2009.

Plain packaging, including prominent and standardised health warnings and minimal manufacturer information, became compulsory for all cigarette and hand-rolling tobacco packs manufactured after May 2016 and sold after May 2017.[76]

United States

A Surgeon General's warning on a cigarette pack, 2012

In 1966, the United States became the first nation in the world to require a health warning on cigarette packages.[77][78]

In 1973, the assistant director of Research at R.J. Reynolds Tobacco Company wrote an internal memorandum regarding new brands of cigarettes for the youth market. He observed that, "psychologically, at eighteen, one is immortal" and theorized that "the desire to be daring is part of the motivation to start smoking." He stated, "in this sense the label on the package is a plus."[79]

In 1999, Philip Morris USA purchased three brands of cigarettes from Liggett Group Inc. The brands were: Chesterfield, L&M, and Lark.[80] At the time Philip Morris purchased the brands from Liggett, the packaging for those cigarettes included the statement "Smoking is Addictive". After Philip Morris acquired the three Liggett brands, it removed the statement from the packages.[81]

Though the United States started the trend of labeling cigarette packages with warnings, today the country has one of the least restrictive labelling requirements on their packages.[82] Warnings are usually in small typeface placed along one of the sides of the cigarette packs with colors and fonts that closely resemble the rest of the package, so the warnings essentially are integrated and do not stand out with the rest of the cigarette package.[82]

However, this is subject to change as the Family Smoking Prevention and Tobacco Control Act of 2009 requires color graphics with supplemental text that depicts the negative consequences of smoking to cover 50 percent of the front and rear of each pack. The nine new graphic warning labels were announced by the FDA in June 2011 and were required to appear on packaging by September 2012, though this was delayed by legal challenges.[83]

In August 2011, five tobacco companies filed a lawsuit against the FDA in an effort to reverse the new warning mandate. Tobacco companies claimed that being required to promote government anti-smoking campaigns by placing the new warnings on packaging violates the companies' free speech rights.[84] Additionally, R.J. Reynolds, Lorillard, Commonwealth Brands Inc., Liggett Group LLC and Santa Fe Natural Tobacco Company Inc. claimed that the graphic labels are an unconstitutional way of forcing tobacco companies to engage in anti-smoking advocacy on the government's behalf.[85] A First Amendment lawyer, Floyd Abrams, represented the tobacco companies in the case, contending that requiring graphic warning labels on a lawful product cannot withstand constitutional scrutiny.[86] The Association of National Advertisers and the American Advertising Federation also filed a brief in the suit, arguing that the labels infringe on commercial free speech and could lead to further government intrusion if left unchallenged.[87]

On 29 February 2012, US District Judge Richard Leon ruled that the labels violate the right to free speech in the First Amendment.[88] However, the following month the US Court of Appeals for the 6th Circuit upheld the majority of the Tobacco Control Act of 2009, including the part requiring graphic warning labels. In April 2013 the Supreme Court declined to hear the appeal to this ruling, allowing the new labels to stand. As the original ruling against the FDA images was not actually reversed, the FDA will again need to go through the process of developing the new warning labels, and the timetable and final product remain unknown. Also, rulings of the 6th Circuit are precedential only in the states comprising the 6th Circuit, i.e., Michigan, Ohio, Kentucky, and Tennessee.[89][90][91][92]

In March 2020, the FDA approved a set of 11 new graphic warning labels with images for cigaratte packaging, with a deadline of compliance being set to June 18, 2021. The mandate would have required packaging to cover the top 50% of the front and rear panels of packages, as well as at least 20% of the top. Tobacco manufacturers R.J. Reynolds Tobacco Co., Philip Morris USA, ITG Brands LLC and Liggett Group LLC filed a joint motion requesting a preliminary injunction on implementing the labels and a ruling to prohibit enforcement in April 2020. They argued that the new packaging would have been a violation of the First Amendment. In December 2022, U.S. district judge J. Campbell Barker of the Eastern District of Texas ordered the new guidelines to be vacated, arguing the multiple interpretation of images cannot prove neutrality. The deadline was pushed to November 6, 2023.[93]

Cigars

Stronger warning labels started to appear in May 2010, but are yet to be officially implemented.

Smokeless tobacco

A can of Copenhagen with a warning label
The four warning label variants seen on various chewing tobacco products sold in the United States

Effective June 2010, the following labels began to appear on smokeless tobacco products (most of which are chewing tobacco) and their advertisements.

The new warnings are required to comprise 30 percent of two principal display panels on the packaging; on advertisements, the health warnings must constitute 20 percent of the total area.[94]

Uruguay

In Uruguay, a variety of warnings with graphic, disturbing images of tobacco-related harms (including lung cancer and mouth cancer) are placed prominently on cigarette packages.

Venezuela

Since 1978 in Venezuela, the only warning in cigarette packs was printed in a very small typeface along one of the sides:

"Se ha determinado que el fumar cigarrillos es nocivo para la salud – Ley de impuesto sobre cigarrillos" (It has been determined that cigarette smoking is harmful to your health – Cigarette Tax Law)

On 24 March 2005, another warning was introduced in every cigarette pack, similar to what was implemented in Brazil: "Este producto contiene alquitrán, nicotina y monóxido de carbono, los cuales son cancerígenos y tóxicos. No existen niveles seguros para el consumo de estas sustancias" ("This product contains tar, nicotine and carbon monoxide, which are carcinogenic and toxic. There are no safe levels for consumption of these substances").

The 1978 warning was not removed, so now every cigarette pack contains both warnings (one on each side).

In addition, since 24 March 2005, as part of the "Venezuela 100% libre de humo" (100% smoke-free Venezuela) campaign, one of the following warnings is randomly printed very prominently, along with a graphical image, occupying 100% of the back of the pack (40% for the text warning and 60% for the image):

Curiously, these warnings only appear on cigarette packs and not on other tobacco products (which only use the 1978 warning).

Vietnam

The following warnings appear on Vietnamese cigarette packages since 2013, along with graphic, disturbing images of tobacco-related harms:

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External links

Wikimedia Commons has media related to Cigarette packet warning signs.