Graphic Health Warning in Bangladesh: Poor Implementation Puts the Poor at Risk

DHAKA, July 30 (NsNewsWire) — Graphic Health Warning (GHW) warns tobacco users about the dangers they will face as a result of this addiction. GHWs have the potential to communicate risks of smoking up to 7000 times a year with smokers who consume a packet of cigarettes every day. In line with the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), the govt. of Bangladesh amended the 2005 Smoking and Tobacco Products (Usage) Control Act in 2013 and made GHW (colored pictures on the harms of tobacco consumption) obligatory on the top 50 percent of tobacco (combustible and smokeless) packs, containers and cartons sold after 19 March, 2016. Under the Act, seven pictures and text warnings are prescribed for combustible tobacco, and two for smokeless tobacco (SLT) products. Warnings must be rotated every three months. Besides, all imported and locally manufactured tobacco packs must be labeled ‘for sale in Bangladesh only’. Violations of GHW requirements are punishable by imprisonment for a term not exceeding six months or a financial penalty of up to BDT 200,000 or both. Penalties are doubled for every subsequent violation. A study recently published in Tobacco Control has found widespread non-compliance regarding the implementation of GHW in Bangladesh. The study titled Graphic Health Warnings on Tobacco Packets and Containers: Compliance Status in Bangladesh also points out potential areas for improvement which will eventually curb the overall consumption of tobacco in the country.

This study describes and analyses compliance with tobacco product graphic health warning (GHW) legislation introduced in Bangladesh in March 2016.

A survey based on a structured questionnaire was conducted in April 2016 (immediately following the law coming into force), and 8 months later in November 2016, in eight divisional cities in Bangladesh. Five stores from three categories of retailers of combustible and smokeless tobacco products were surveyed, providing a total of 120 completed questionnaires. The study investigated a range of measures including the image and text of GHW, their ratio and color use, and prescribed rotation.

Warning labels for 3312 tobacco items were assessed. In April 2016, 75% of tobacco products surveyed did not have GHWs. In November 2016, 19% were still found to not have the prescribed warnings. Even among products which did include GHW, there was significant non-compliance with the full range of requirements, in both survey periods. Compliance was highest for cigarette packets and lowest among smokeless tobacco products. Zarda packets and containers had the highest proportion of products with no GHW (40%), followed by gul (24%) and bidi (14%). In November 2016, more than 90% of the bidi packets did not place the GHW in the appropriate place. Approximately 42% of gul containers were found not to follow the guidelines on placement. Zarda products also had a high level of non-compliance; more than 85.2% had the image and text incorrectly placed. In addition, awareness among tobacco retailers about the range of GHW requirements was low.

Recommendations

• Campaign among retailers and other stakeholders

According to the findings of the study, around 31% of the retailers did not know that selling tobacco product without GHW is punishable under the law. If retailers are well-informed about the images and warning text approved for current round and the way these need to be shown on the packets and containers, it may create pressure on the producers to comply with government directives, particularly if compliance measures are introduced. Awareness-raising strategies such as retailer seminars, meetings, and campaigns both in urban and rural areas will deliver effective result in this regard.

• A law enforcement approach

Frequent but irregular mobile courts may be operated to investigate tobacco shops. Penalties may be imposed publicly against violating tobacco producers. For instance, open destroying or burning of non-compliant tobacco products may be an option.

• Ensuring standardization and greater supervision

The poorly-organized, home-based and labor-intensive bidi and SLT sector need to be brought under standardization and a central supervision because these cheap products are used by the majority of the tobacco users. Local level administration can play a vital role regarding this.

• A total lawful implementation of GHW

The existing tobacco control law of Bangladesh dictates the GHW to be printed on the top 50 percent of all tobacco packs, containers and cartons. Health researchers and tobacco control experts also advocate for GHW placement at the top of tobacco packets for more effective result. However, after the GHW rules have been passed, tobacco companies have successfully lobbied for them to remain on the lower half, arguing that tax stamps and band roll are attached to the top flap, which would require new technology and thereby create difficulty for implementation. The baseless claim of tobacco industry and its repeated interference in policymaking has been thwarting the proper implementation of GHW for the last five years. A brave action is necessary from our policymakers’ part to shake off the industry interference and manipulation and ensure proper implementation of GHW as dictated in the law. Source: Progga Media Brief