Canada adopts health warnings on cigarettes

On May 31, 2023, Canada became the first country to announce the requirement to print health warnings on cigarette paper. This measure will take effect on May 1^er August 2023 and will be gradually implemented.

In 2001, Canada had already been a pioneer in imposing graphic health warnings on cigarette packages, a measure quickly followed by other countries and considered one of the best practices in consumer information and prevention. Announced in June 2022, the proposal to print health messages on the cigarettes themselves is about to become a reality and is also a world first.

"Poison in every puff"

On May 31, 2023, World No Tobacco Day, Health Canada unveiled the new health warning measures that were to be published on June 7, 2023.[1]. These include printing health messages on cigarette paper and are specifically aimed at keeping young people away from tobacco. Since young smokers are more often offered individual cigarettes, health messages will be essential here. Placed on the paper surrounding the filter, these messages will also have to appear on cigarillos and cigarette tubes.

Manufacturers are required to follow a set of six health messages. These messages, available in French and English, remind us that "Cigarettes damage your organs," that "Tobacco smoke harms children," and that "Poison in every puff."

The idea of health messages on cigarettes is old, having been formulated as early as 1979 in the United Kingdom. Australia and the United Kingdom have also been studying this option for several years. The Canadian government itself has been working on this theme since 2018, at the time of a public consultation. The measure comes into force on 1^er August 2023, but in a progressive manner, notably depending on the type of tobacco product. King size cigarettes (length 83 to 85 mm) will have to carry health warnings by July 31, 2024, while standard cigarettes (length 70 to 73 mm) and cigarillos will have a delay until April 30, 2025.[2].

Expansion and renewal of health warnings

This world first is accompanied by other measures concerning tobacco product packaging. 14 new graphic health warning templates have been issued to update the messages and dissuasive illustrations, and are supplemented by advice on quitting smoking. These warnings will now cover 75% of the surface area of the cigarette pack and must be implemented by April 30, 2024. Another 14 health warning templates will be proposed two years later. This method has the advantage of leveraging the FCTC Article 11 Implementation Guidelines, which constitute the most recent recommendations on health warnings, while also taking advantage of existing legislation. Tobacco products previously not covered by health warnings, such as snuff or shisha tobacco, will now have to display them.

These measures have been applauded by all health stakeholders, who are calling for others to be taken, such as the ban on flavorings in vaping products.[3], a single measure is not enough to eliminate smoking and nicotine addiction. Canada's goal remains to achieve a tobacco-free generation, meaning fewer than 5,000 smokers in the population, by 2035. Smoking prevalence was only 10,000 in 2020 (including 8,000 daily smokers).[4], but tobacco still kills 48,000 people each year in Canada.

Keywords: Canada, health warnings, cigarette paper, poison.

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[1] Canada to become first country in the world to require health warnings on individual cigarettes, Health Canada, published May 31, 2023, accessed June 6, 2023.

[2] Miller A, Cigarette warning labels are about to get even harder to ignore in Canada, CBC News, published May 31, 2023, accessed June 6, 2023.

[3] Smoking warnings soon to be printed on every cigarette, Radio-Canada, published May 31, 2023, consulted June 6, 2023.

[4] Canadian Tobacco and Nicotine Survey (CTNS): summary of results for 2020, Statistics Canada, published April 1, 2022, accessed June 6, 2023.

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