Implementation of Pictorial Health Warnings on Tobacco & Tobacco Products

Introduction: Ghana has made progress on tobacco control in recent years. Even though fewer men on average smoke in Ghana than in high income countries, there are still more than 425,200 men, 69,200 women and 2,700 boys who smoke cigarettes each day, killing about 75 men a week and making it an on-going and dire public health threat (Tobacco Atlas Ghana). Having the vision to create a tobacco free society and to foster individual, community and government responsibility, the Food and Drugs Authority (FDA) Ghana with support from other stakeholders in Tobacco Control has implemented most of the WHO Framework Convention on Tobacco Control (WHO FCTC). Graphic Health Warnings (GHW) have proven to be more effective in communicating the health hazards related to tobacco use, making the need for Ghana to adopt and implement the use of GHW obvious.

Methodology: A pre-test of the prototype tobacco warning was done in the northern, middle and southern belts of Ghana. The pre-test involved 90 respondents selected purposively and the data collection tool was by opened-ended questionnaires and interviews. The respondents were expected to identify technical content, readability, layout, aesthetics, clarity and sensitivity. The outcome of the pre-test was forwarded to and deliberated among key stakeholders.

Results and Discussion: 76 respondents were able to identify the proposed pictures. However, 23 people found it difficult to understand and 67 understood with little difficulty. The message conveyed by the pictures was well understood by 77 participants. On a scale of, very easy, easy and difficult, 69 respondents found the message very easy to understand. The respondents learnt new things such as “smoking can cause leg cancer, throat cancer or damage to mouth palate etc”. 47 respondents said the message encouraged them to avoid smoking whereas 21 were encouraged not to smoke again. 69 people found the images sensitive especially because of the nature of the cancers. The recommendations of the pre-test were considered and the appropriate images were validated and approved by stakeholders. The Food and Drugs Authority (FDA) met with the Tobacco industry to discuss the implementation of the approved GHW on packages of tobacco and tobacco products.

 Conclusion: Ghana stopped the importation of tobacco products without GHW in April 2018 and gave importers till November 2018 for all tobacco products on the Ghanaian market to bear GHW. Ghana has currently three pairs of Graphic Health Warnings which are used alternatively on the principal display areas on packages of tobacco products.