Come September 1 and all tobacco products sold in the country will display pictorial as well as textual health warnings and a toll-free ‘Quitline’ number. It’s the first time a ‘Quitline’ number is made mandatory on all tobacco product packets.

The Union health ministry’s decision to tighten curbs on tobacco product sales comes only days after its order to extend the duration of existing pictorial warnings till August 3.

In its latest move, the ministry has issued a second amendment to the Cigarettes and other Tobacco Products (Packaging and Labelling) Rules, 2008, to further tighten the pictorial warning norms. Along with the Quitline number, a new set of shocking and gruesome health warning pictures, to be displayed on packets to make people understand the risks of tobacco use, are also issued.

The government’s uncompromising stance is immediately cheered by anti-tobacco activists and advocacy groups who point out that the decision to add a Quitline number is prompted by the data obtained from Global Adult Tobacco Survey (Gats) 2016-17. “The new measure is highly laudable. The authorities have successfully stared down pressure from the tobacco lobby that usually raises the issue of farmers and beedi industry workers to subvert anti-tobacco campaigns,” Binoy Thomas of Voluntary Health Association of India (VHAI) told Pharmabiz. A Delhi-based non-profit, VHAI is a federation of 27 state voluntary health associations, and has been in the forefront of tobacco-control campaigns across the country.

Regarding pictorial warnings, the ministry order stated: “During the rotation period, there shall be two images of specified health warning which shall appear consecutively on the package with an interregnum period of twelve months…The date of coming into effect of the second image of specified health warning shall be for all tobacco products manufactured or imported after the completion of twelve months from the date of commencement of first image.”

For smoking and smokeless forms of tobacco products, the message ‘Tobacco causes cancer’ and “Tobacco causes painful death’ will appear in white font colour on a red background and the words ‘Quit Today Call 1800-11-2356’ will appear in white on a black background. The ministry has also specified the intensity of colour in the background of the textual warning. They should be printed with four colours with a resolution of minimum 300 dots per inch. The font type and colour of the health warning should be exactly as specified.

“The Gats survey finding was indeed an eye-opener. It became clear that anti-tobacco campaigns and pictorial warnings on packs will yield results in a country like India where socioeconomic and demographic factors play a crucial role,” Anita Peter of Cancer Patients Aid Association (CPAA), a non-profit active in anti-tobacco initiatives, opined.

The Gats survey had proved beyond doubt the effectiveness of the pictorial warnings as 62per cent of cigarette smokers and 54 per cent of beedi users said they had thought of quitting because of the gory images on the packets. As many as 46 per cent of smokeless tobacco users also thought of quitting because of the warnings. The survey also revealed that pictorial health warnings on packets were the most cost-effective tool for educating on the risks of tobacco use.

India, in the recent past, has made its anti-tobacco regulations stricter and harsher. The present pictorial health warnings on tobacco products came into effect from April 2016 on the direction of Rajasthan high court, which was later upheld by the Supreme Court. In January this year, the apex court had stayed an order by the Karnataka high court which scrapped the regulation that tobacco product packages must have a pictorial warning covering 85 per cent of the space.

Last week the ministry had amended the Cigarettes and other Tobacco Products (Packaging and Labelling) Rules to make sure that the warning will continue on packets till August 31. As per the amendment, "if the specified health warnings provided are not amended by the Central Government with new specified health warnings at the end of the rotation period for the next rotation period, then the existing specified health warnings for the second twelve months shall continue for a further period till August 31".