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Larger Labels Increase Smoker Knowledge of Risks

Media release
16 June 2006

Larger Labels Increase Smokers’ Knowledge of Health Risks and Intent to Quit – new study

The Cancer Society is urging the New Zealand Government to enact larger, graphic health warnings than those proposed in its Review of the Smoke-free Environments Regulation.

New research shows that smokers in countries that require large, graphic health warning labels on cigarette packs are more likely to recognise disease risks from smoking. They are also more likely to be motivated to quit smoking.

“This reinforces the need for larger health warnings,” says Belinda Hughes, Tobacco Control Adviser to the Cancer Society.

The Cancer Society would like to see health warnings covering 80 percent of both sides of tobacco product packaging as a first step. At a minimum it would expect health warnings to cover 50 percent of the front and 90 percent of the back of cigarette packaging.

“The Ministry of Health proposal is for 30 percent on the front and 90 percent on the back or 50/50 and we do not believe that is nearly enough,” Ms Hughes says.

“Research shows that the larger the warnings the more effective they are. The current proposal from the Ministry of Health is far too conservative,” she says. "The options presented by the Ministry provide more prominence for the marketing of cigarettes than the communication of the impact of smoking."

The recent study compared smokers in four countries – Canada, Australia, the United Kingdom, and the United States – that have widely varying requirements for cigarette warning labels.

The warnings are most prominent in Canada which requires the rotation of 16 warnings that cover 50 percent of the front and back of the cigarette pack and include colour pictures.

Australia (at the time of the study) rotated six black and white text warnings that cover 25 percent of the front and 33 percent of the back of the pack. (They increased this from March 1, 2006 to 30 percent on the front and 90 percent on the back)

The United Kingdom requires six rotating warnings in black and white text on six percent of the face, while the United States, where the warnings are least prominent, requires four rotating warnings in black and white on the side of the pack.

The study found that more prominent warnings had a positive impact both on smokers’ knowledge of health risks and intent to quit:

- Eighty-four percent of Canadian smokers reported the cigarette package as a source of information on the dangers of smoking, compared to 69 percent of Australian smokers, 56 percent of UK smokers, and 47 percent of U.S. smokers.

- Nearly half (49 percent) of Canadian smokers recognised all five health effects of smoking addressed in the survey (lung cancer, heart disease, stroke, impotence, and lung cancer in non-smokers exposed to second-hand smoke), while no more than 27 percent of the smokers in any of the other three countries recognised all five.

- Smokers who were aware of each of the health effects of smoking were more likely to say they intended to quit smoking in the next six months. In addition, the more total health effects recognised, the more likely smokers were to say they intended to quit.

“Clearly the health warnings on packaging have real impact. It’s a real opportunity to help smokers save their own – and others’ – lives. Why would you take half-measures?” Ms Hughes says.

A quarter of cancer deaths are caused by smoking and lung cancer is the leading cause of cancer death for both Maori and Non-Maori (Ministry of Health. 2004a. Mortality and Demographic Data 2000. New Zealand Health Information Services. url:


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