Qatar: warning about the dangers of tobacco (health warnings)

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Context

Qatar took the lead among the countries of the Gulf Cooperation Council and the WHO Eastern Mediterranean Region by ratifying the WHO Framework Convention on Tobacco Control (FCTC) on 23 July 2004. Two years prior, Qatar introduced its first tobacco control law, Law No. 20 of 2002. This law served as a robust and comprehensive foundation for tobacco control efforts in the country, incorporating various measures within a single legislation. Notably, Article 6 of the law mandated the labelling and packaging of all tobacco products, including the adoption of textual health warnings. Additionally, Article 13 established penalties for violations. The law also provided a definition for tobacco and its products and required health warnings to be displayed in both Arabic and English, containing information about constituents and emissions.

However, since the enactment of this tobacco control law in 2002 and the ratification of the WHO FCTC in 2004, no further amendments or complementary regulations were introduced to align the requirements for tobacco packaging and labelling with the guidelines outlined in Article 11 of the WHO FCTC. Thus, there was a need for a more comprehensive adoption of the Article 11 guidelines to more effectively contribute to the tobacco control plan. The aim was to reduce tobacco consumption, raise awareness about the hazards of smoking and encourage smokers to quit, while enhancing public understanding of the harmful effects of tobacco use.

Initiative

Through collaborative efforts with other countries of the Gulf Cooperation Council, Qatar has developed the GSO 246/2011, a packaging and labelling standard for tobacco products established by the Gulf Cooperation Council Standardization Organization in 2011. The adoption of this standard involved extensive meetings and discussions to approve unified specifications for pictorial health warnings on tobacco products, ensuring compliance with the requirements of the WHO FCTC across all countries of the Gulf Cooperation Council. Ongoing collaboration took place between the Gulf Cooperation Council Tobacco Control Committee, the Standards and Specifications Committee and the ministries of trade and commerce. The GSO 246/2011 aligned with a broader set of guidelines outlined in Article 11 of the WHO FCTC, specifically addressing size requirements (occupying at least 50% of the main display areas) and content (including both text and pictures).

In 2012, Qatar issued a circular based on the GSO 246/2011, adopting the standard and prohibiting the import and sale of tobacco packages without the required pictorial health warnings. Tobacco companies were given a grace period of three months to comply. The circular stipulated that health warnings must consist of text and images issued by the Ministry of Public Health, adhering to the approved standard specifications. According to GSO 246/2011, the warnings should cover 50% of the front and back main display areas, with text occupying no more than 40% of the total warning space. The warnings should be presented in both Arabic and English languages. Information should be directly printed on the carton, not on external film wrappers or carton labels. Health warnings must be printed clearly and legibly, using bold font with a minimum size of 12, and in a font colour that contrasts with the carton's background colour. Additionally, the law requires periodic rotation of the warnings, with a recommended rotation interval of 12 to 36 months, to ensure the effectiveness of the graphical warnings. Individual packages must include the product name, trademark, number of cigarettes, production date, batch number, country of origin, manufacturing or packaging details, percentage of tar, nicotine and carbon monoxide, and the statement "For sale in Gulf Cooperation Council countries". Furthermore, health warnings are mandatory on the outer packaging of all tobacco products, while chewing tobacco and dipping tobacco (sweika) are prohibited.

In 2014, the Gulf Cooperation Council Standardization Organization issued another GSO that defined permissible and impermissible tobacco additives. In 2016, Qatar enacted a new, more comprehensive tobacco control law, which, in its Article 6, explicitly mandated that tobacco packages bear both textual and pictorial warnings about the harms of tobacco use, as specified by the relevant ministerial administration. The law also established stricter penalties and higher fines for violations in its Article 16. A circular was issued to tobacco companies, instructing them to apply the required pictorial and textual health warnings on both outer and inner tobacco packages, in addition to the instructions given in 2012.

Challenges and lessons learnt

One of the main challenges encountered in implementing pictorial health warning labelling on tobacco packages in Qatar is ensuring compliance at points-of-sale, particularly establishments selling waterpipes. This is due to the nature of these premises, typically restaurants or hotels, where tobacco preparation occurs away from customers' direct view, making it difficult for them to see the health warnings.

While the GSO 246/2011 aligns with the guidelines of Article 11 of the WHO FCTC, certain requirements were not explicitly addressed. These include:

Placing the warning at the top of the primary display areas of the package and ensuring its presence on each package and any external packaging and labelling used in retail sale.

Prohibiting the display of quantitative information on emission yields (such as tar, nicotine and carbon monoxide), including when incorporated as part of a brand name or trademark, and restricting the display of qualitative information on relevant constituents and emissions of tobacco products on packaging and labelling.

Restricting the display of expiry dates on tobacco packaging.

Requiring the inclusion of a quitline number on packaging or labelling.

Mandating plain packaging.

Impact

Although the precise impact of implementing pictorial health warnings on tobacco products has not been measured, insights from the Global Youth Tobacco Survey of 2018 reveal that 36.1% of current young smokers expressed contemplating quitting due to the presence of warning labels. This tobacco control measure contributes to reducing tobacco consumption and aligns with Qatar's objective of promoting smoking cessation by discouraging smoking behaviour.

Next steps

Qatar is currently developing a proposal to adopt plain packaging for tobacco products, following the successful implementation of this tobacco control measure in other regions like Europe, the United Kingdom and Australia. Qatar envisions that plain packaging will contribute to reducing the appeal of smoking, particularly among young people. Additionally, Qatar is exploring the possibility of including quitline numbers and services on tobacco packages to actively encourage tobacco users to quit smoking.

References

Global Youth Tobacco Survey

MPOWER measures to reduce demand for tobacco

WHO Framework Convention on Tobacco Control

Story originated in 2019.