Experts are dismayed at the increasing incidence of cancers in India and in Kerala even as the fate of 85 per cent tobacco product pictorial pack warnings - a life-saving tobacco control measure - hangs fire. 

This comes in the backdrop of various National and International studies that have inarguably articulated that tobacco use is a major cancer-inducing factor.The National Cancer Registry Programme of the Indian Council of Medical Research (ICMR) puts cancer cases in the country in 2016 at 3.9 million. Of the total cancer cases, Kerala accounted for a significant 1,15,511 cases. Meanwhile, the Population-based Cancer Registries of Trivandrum, Kollam and Malabar had reported an estimated 66,000 plus new cancer cases in Kerala in 2016. 

Dr Paul Sebastian, Director, Regional Cancer Centre here said, “The cancer scenario in the country and the state calls for a focused emphasis on preventive measures through tobacco control.”The 85 pictorial pack warnings have come to be recognised as a cost-effective means of communicating tobacco harms among youngsters, migrants and illiterates, and preventing them from getting addicted. Any step backward in the fight against tobacco use will pinch our cancer control efforts,” Dr Sebastian said.
As per the Global Adult Tobacco Survey (GATS 2016-17) of the Union Minister of Health and Family Welfare and the World Health Organisation, 61.9 per cent of cigarette smokers, 53.8 per cent of bidi smokers and 46.2 per cent of smokeless tobacco users thought of quitting because of 85 per cent product pack warnings.

Dr Pankaj Chaturvedi, Oncologist, Tata Memorial Hospital and a Member of the Expert Committee set up by Union Health Ministry said, “The judgement of Karnataka High Court is a setback to the Government’s trendsetting initiatives on tobacco control. I participated in the selection of images of real patients to be used as warnings on tobacco products. Such images are globally considered the most effective way of communicating hazards of tobacco usage.In India too, they have been really effective as there has been 6 percent reduction in tobacco use and 81 lakhs lives have been saved as per the recently released GATS results”, Dr Chaturvedi added. 

On the psychological effects of pictorial warnings Dr S.Satheesh Nair, President of Government Clinical Psychologists Association said, “It is common knowledge that a picture is worth a thousand words. The eye captures the visual input and processing of shape, colour;+ and orientation of the image happens in the brain. Research conducted by MIT has shown that the brain can process the meaning of an image at 13 milliseconds.”

Strongly recommending 85 per cent pictorial pack warnings, he added, “Large pictures can increase warning attention, recall, and message processing, explaining why increased number of smokers/users thought of quitting. Tobacco-using adults will be wary of sending children to purchase packets fearing how large and gruesome pictures would affect the child’s psyche.”