Back of pack picture warnings on cigarettes 'less visible to young people'

In collaboration with the Press Association

Graphic picture warnings on the back of cigarette packs have little effect in deterring teenage smokers, a new UK study suggests.

Research from the Centre for Tobacco Control Research at the University of Stirling found that picture warnings are more efficient than words. But putting them on the back of packs makes them less visible and effective to young people, according to results published in the journal Tobacco Control.

Cancer Research UK say the research highlights the need for picture warnings on both the front and back of packs.

Under current laws, pictures showing diseased lungs, rotten teeth and neck cancer are only printed on the back of cigarette packs.

The European Parliament is due to vote on whether these warnings should appear on both sides, and the new research indicates that a change in the rules could help dissuade more teenagers from smoking.

The vote had been set to take place next week but, following a campaign by the tobacco industry, has been pushed back to 8th October.

The latest findings come from two surveys. More than 1,000 youngsters aged 11 to 16-year-old were questioned in 2008 and another 1,000 were surveyed in 2011.

Most of the teenagers in both surveys (68 per cent to 75 per cent) had never smoked, but 17 per cent to 22 per cent said they had experimented with cigarettes.

Around one in 10 were already regular smokers who smoked at least one cigarette a week.

Half of those questioned in both surveys said they had 'often' or 'very often' noticed the warnings on packs, and around one in five said they had read them very often or looked closely at them.

The number of teens saying the warnings put them off smoking increased between the two surveys. But among regular smokers, the proportion who said that the warnings stopped them from having a cigarette fell from 32 per cent to 23 per cent.

Results showed that while teenagers' ability to recall the picture images remained below 10 per cent, text warnings on the back of packs with no supporting images were recalled by less than one per cent.

Picture warnings are designed to provide reminders about the dangers of tobacco. But researchers said that because the UK has been using the same pictures since 2008, this may have increased the "wear out" factor, particularly for regular smokers.

The authors wrote: "As warnings need to be salient to be effective, positioning pictorial warnings only on the less visible reverse panel limits their impact."

They added: "Positioning pictorial warnings only on the back of packs may have had a deterrent effect on never and experimental smokers, but for most measures no significant differences were observed. The impact on regular smokers was negligible."

Alison Cox, Cancer Research UK's head of tobacco policy, said: "We know that well-placed picture warnings work and discourage young people from starting to smoke so we're delighted that the European Parliament will vote on legislation for picture warnings to appear on both sides of cigarette packs.

"UK law requires picture warnings to appear only on the back of the pack. This research shows why European legislation is so important.

"In the UK 207,000 young people start smoking every year and - of those who go on to be long term smokers - half will die of a smoking-related illness.

"We must do all we can to protect the next generation from becoming tomorrow's tobacco addicts."

Copyright Press Association 2013


  • Moodie C., Mackintosh A.M. & Hastings G. (2013). Adolescents' response to pictorial warnings on the reverse panel of cigarette packs: a repeat cross-sectional study., Tobacco control, PMID: