South Korea: Tobacco Packages Must Feature Visual Warnings


Lee Sung-pyo, a 30-year-old office worker, visited a duty-free shop during his travels to Macau in September. A heavy smoker, he has a habit of buying cigarettes in cartons every time he visits duty-free shops, where the price is much lower. Upon picking up the product, he was shocked to see a large photo of a decomposed foot printed on the box.

"I've read about those photos before,' he said, "but it was the first time seeing them in person. Although I did end up buying them, I sometimes lose the urge to smoke when I see them.'

These warning signs became obligatory in Korea, as well, starting Friday.

The signs on cigarette packages will present ten images associated to smoking's harmful effects, from cerebral stroke, lung cancer and sexual dysfunction to skin aging. Such photos include a laryngeal cancer patient with a hole in the neck and a pregnant mother's cigarette smoke heading to her baby.

Visual warning signs on cigarette packs are the most representative non-price policy for nonsmoking. Its implementation in Korea was decided in June last year when the reformed bill for public health made it through the National Assembly.

Lowering the smoking rate by lifting prices already started in January 2015, when cigarette prices jumped from 2,500 won ($2.08) to 4,500 won per package. The measure has proven to be effective so far, according to the public health report published by the Ministry of Health and Welfare last month.

The smoking rates of men aged over 19 years fell 3.8 basis points from the previous year, the report said, to record an all-time low of 39.3 percent. The government has high hopes that the visual warning will drop this figure even more.

The changed law states that every cigarette package should include warning images. Six stores in Seoul were appointed to start sales of the new versions immediately, as a way to inform the public on the new law before the new cigarette packs reach retailers a few months from now.

But others will have to wait until late January, as most cigarettes just made will not be available until current supplies are all sold out. "It generally takes about one month for a freshly manufactured cigarette to land in convenience stores,' said Kwon Byung-gi, an official at the Ministry of Health and Welfare. "New packages of popular brands may show up as early as late January.'

The image should take up 30 percent of the front and back sides each, apart from the space dedicated to warning phrases. Photos will also be exchanged every two years, since familiarity can reduce the efficacy of the images.

Three sides of the package will have an image or phrase to discourage smoking. Apart from the photos, a verbal warning will also be included.

On the back, there will be a brief sentence that lists the carcinogenic elements in tobacco from benzene and cadmium to nickel. The phrase "Tar intake can differ according to your smoking habits' will be printed on one side.

Boxed cigarettes are not the only type of tobacco subject to the changed law. E-cigarettes, Cavendish tobacco, hookah and snus, a Swedish variant of snuff, must also include visual warnings. The law will apply to cigarettes sold in duty-free shops, as well.

However, there remain obstacles for successful implementation. Retailers could block theses warning signs with price tags. As there are no rules about this, such actions cannot be punished. To prevent this, the Ministry of Health and Welfare plans to propose a reformed bill to ban retailers from using shelves to hide warning signs.

Another concern is the possibility that tobacco companies have amassed packages without warnings by boosting their outputs before last Friday. The ministry is said to have already checked on the country's only tobacco manufacturer, KT&G, earlier this month, but found no evidence of this.

But the exact output since then is unknown as the manufacturing site was not continuously inspected. "The tobacco industry already expressed its will to cooperate, so a sudden boost in cigarette storage is unlikely,' said Kwon Byung-gi. "We'll continue efforts to monitor the market situation with the help of the Ministry of Strategy and Finance.'

Some complain that the photos are too uncomfortable to watch, saying that the gruesome images violate human rights.

Nonsmoking advocates say the visual warnings should be the start of even stronger measures. "The line-up of photos used should be increased from ten to twenty to include diseases relatively unknown that occur from smoking, such as pancreatic cancer and leukemia,' said Seo Hong-kwan, professor of the National Cancer Center and head of the Korean Association on Smoking or Health. "People should know that what's uncomfortable is not the images, but the fact that smoking can bring such consequences.'

Cho Hong-jun, a doctor of family medicine at Asan Medical Center in Seoul, agreed. "After two years of trial,' he said, "the policy should be enforced by printing more harsh images or enlarging the photos' sizes. The ultimate goal should be 'plain packaging' as in the U.K. and Australia, which bans flashy colors and designs from cigarette packs.' Enditem