Larger Health Warnings to reduce the number of Smokers

European Union diplomats approved new anti-tobacco legislation on Wednesday, December 18,  including larger health warnings on cigarette packets and the bloc's first rules on electronic cigarettes.

The new rules are designed to make smoking less attractive - particularly to young people - in a bid to reduce the estimated 700,000 tobacco-related deaths in Europe every year.

"Agreement on the tobacco directive is a big step towards a healthier and more prosperous society," said Vytenis Povilas Andriukaitis, the health minister of Lithuania, which currently holds the rotating EU presidency.

The deal was struck after governments and the European Parliament resolved a dispute over how tightly to regulate the market for e-cigarettes.

Some analysts predict e-cigarette sales will eclipse the $700 billion-a-year market for ordinary cigarettes in 10 years. Big tobacco firms, including Philip Morris owner Altria, British American Tobacco and Imperial Tobacco have all moved into the sector to offset declining cigarette sales, particularly in developed countries.

Under the agreement, most e-cigarettes can be sold as consumer products rather than as more tightly regulated medical devices, as governments had initially wanted. Countries will be free to regulate e-cigarettes as medicine if they choose.

Refillable e-cigarettes will be allowed, but the European Commission could impose an EU-wide ban in future if three or more member states prohibit them on health grounds.

From 2016, when the rules changes will take effect, cigarettes, rolling tobacco and other products will have to carry graphic picture and text warnings covering 65 percent of the front and back of packets.

Countries that are contemplating bans on all cigarette branding, such as Britain and Ireland, will be able to introduce so-called plain packaging if they wish.

MENTHOL BAN

Cigarette makers described the rules as disproportionate and questioned the health benefits they would bring.

"Over-sizing health warnings to 65% with pictures positioned at the top of the pack... will not work, as people already understand the health risks associated with smoking," Japan Tobacco Inc said in a statement.

"Rather, these restrictions will confuse retailers and consumers, making it difficult for them to distinguish brands."

But health campaigners said the new requirements would make it harder for companies use misleading marketing to attract new customers.

"The tobacco regulation supported today by governments is a victory against the tobacco industry and its intense lobbying," said Monika Kosinska, secretary general of the European Public Health Alliance.

The rules also include a ban on smoking tobacco products containing flavours such as fruit or vanilla. Menthol cigarettes will be banned from 2020, after some governments demanded a slower phase-out.

Studies show that flavoured cigarettes are becoming increasingly popular among young smokers and often act as a 'gateway' to other tobacco products.

The deal is now expected to be formally approved by EU ministers and the full parliament before entering force next year.

Do you like Menthol Cigarettes? EU will ban soon a few brands

Packs of ten cigarettes could be banned under a European proposal to crack down on smoking.

The EU’s Health and Consumer Commissioner also unveiled plans to ban menthol cigarettes and to force companies to cover three quarters of their packets with a picture warning.

The idea is to make smoking less attractive to children, who are more likely to buy smaller packets of cigarettes with their pocket money. Youngsters are also more likely to buy flavoured cigarettes. 

Flavoured cigarettes, including menthol, strawberry, or vanilla, are set to be banned in the European Union. The EU health commissioner also wants to make pictorial warnings occupy 75% of the pack.

In the proposal there were plans to ban ‘slim’ cigarettes and the sale of packs containing less than 20 cigarettes. 

"We're not prohibiting smoking; we're making it less attractive for everyone," said Tonio Borg of the health commission. "Sometimes you need shocking pictures to shock people into stopping smoking."

Glenis Wilmott, Labour leader in the European parliament, told the Guardian: "Cigarette packets should look like they contain a dangerous drug, rather than perfume or lipstick.”

She also proposed additional measures to curb smoking in the EU, "We need to get rid of all branding from cigarette packets, as it is the only space that the tobacco industry has left to market their products.”

To our knowledge, there have been only three prior studies of the effect of menthol cigarettes on lung cancer risk. Results have been ambiguous, with none showing an increased risk for women but two showing dose-related increases for men. Only one study published race-specific results, with no increases for either Whites or Blacks. At the same time studies conducted to date have not provided a clear answer concerning whether smoking menthol cigarettes increases the risk of lung cancer more than smoking non-menthol cigarettes.

Menthol is a naturally occurring compound with topical cooling and anesthetic properties used in a wide range of products. Menthol cigarettes first appeared in the 1920s, but it was not until the mid-1950s that they came into widespread use. 

Since 1973, menthol varieties have accounted for 25–30% of all cigarettes sold in the United States. There are strong ethnic differences in the use of menthol cigarettes; more than 60% of Black smokers of both sexes use menthol brands compared with fewer than 25 %  of White smokers. 

Lung cancer incidence is 50% higher among Black men than among White men. Although Black men are more likely to smoke, it does not appear that the excess occurrence of lung cancer can be fully explained by a higher prevalence of smoking.