Global Tobacco Control Updates

Stronger cigarette pack health warnings work
13 Oct 2016
Research Alert

A study published in Social Science & Medicine examines the impact of policies that strengthened requirements for health warnings on cigarette packs. Researchers reviewed 32 studies from 20 countries that assessed the impact on knowledge, beliefs, attitudes, intentions and behavior. Most of the studies examined changes from text-only to pictorial health warnings; the remainder examined changes that strengthened either text or pictorial health warnings. Together, the studies involved 812,363 participants.

Key Findings

  • Strengthening cigarette pack health warnings was associated with:
    • Increases in knowledge about smoking harms;
    • Increases in calls to quit lines;
    • Reductions in the number of cigarettes smoked by smokers;
    • Increases in quit attempts; 
    • Reductions in smoking prevalence.
  • Larger changes in the number of cigarettes smoked and smoking prevalence were observed when the policy requiring stronger health warnings was implemented alongside other major tobacco control policy changes than when implemented alone.

Key Messages

  • Graphic health warnings are more effective than text-only warning labels. 
  • Effective health warning labels for tobacco products are large, clear, rotating, cover at least 50 percent of the principal display areas of the package and consist of a combination of both text and graphic images.
  • Article 11 of the WHO Framework Convention on Tobacco Control and its Guidelines obligate Parties to adopt and implement large, clear, and multiple rotating pictorial health warnings on all tobacco products.

Full Citation:Noar et al. The impact of strengthening cigarette pack warnings: Systematic review of longitudinal observational studies. Social Science and Medicine 164 (2016) 118-129.

Full study available [ENGLISH ONLY] from:

Additional Resources:

Social Science and Medicineis a peer-reviewed journal that provides an international and interdisciplinary forum for social science research on health.


graphic warning labels