Alishba Asif
Graphic Health Warnings (GHWs) are one of the most visible and effective ways of communicating the dangers of tobacco use. Found on cigarette packs and other tobacco products, these warnings combine clear text with powerful images to show the real health consequences associated with tobacco consumption. Their purpose is simple: to inform people, remind users of the risks, discourage young people from starting, and encourage current users to consider quitting.
Tobacco use remains a major public health concern around the world. Many people begin using tobacco without fully understanding its long-term consequences. Because tobacco products are often packaged in attractive designs and promoted in ways that can make them appear less harmful than they really are, health warnings provide an important counter-message. Every time a person reaches for a cigarette, the warning on the package can serve as a direct reminder of what tobacco can do to the body.
Unlike advertisements, which are designed to attract attention and create positive associations, graphic health warnings communicate an entirely different reality. Images showing damaged lungs, diseased organs, or other consequences of tobacco use can make health risks more understandable and immediate. For people who may not respond to written information alone, visual messages can be particularly powerful.
GHWs also play an important role in reaching people who may have limited access to health information. A health warning printed directly on a tobacco package travels wherever the product goes. It does not require a person to attend a seminar, read a brochure, visit a health facility, or search for information online. The message is repeatedly displayed to the consumer and can also be seen by family members, friends, and others around them.
For young people, strong health warnings can challenge the perception that tobacco products are fashionable, modern, or socially desirable. When warnings are clear, prominent, and visually compelling, they can help prevent tobacco use from being viewed as harmless or normal. For current users, repeated exposure can encourage reflection on their health, family, future, and the costs associated with continued tobacco use.
Pakistan has made important progress in graphic health warnings, but this progress has remained largely unchanged in recent years. Pakistan increased pictorial health warnings from 50% to 60% in 2019. The 2019 notification introduced a new pictorial warning and increased its size to 60% on both sides of cigarette packs and outers. However, there has been no further increase in the legally required warning coverage since 2019; meaning Pakistan has remained at 60% for approximately seven years.
This prolonged gap highlights the need for a clear and forward-looking strategy from the Ministry of National Health Services, Regulations and Coordination ) and Tobacco Control Cell (TCC), for increasing GHW coverage and strengthening the health warning to reduce tobacco consumption. The ministry should progressively aim for larger warnings size, updated messages, defined timelines for rotation, and regular review of warning effectiveness. A predictable and evidence-based approach would help ensure that Pakistan’s health warnings continue to evolve rather than remaining static for years.
The need for progress is also reinforced by Pakistan’s obligations under the WHO Framework Convention on Tobacco Control (WHO FCTC), particularly Article 11, which addresses the packaging and labelling of tobacco products. Article 11 calls for effective health warnings that are large, clear, visible and legible, and its implementation guidelines specifically emphasize the importance of rotating health warnings and messages. The WHO FCTC guidance explains that the effectiveness of repeated warnings can decline as people become accustomed to them, while changing warnings can restore attention and increase their impact
Pakistan’s position can also be viewed in comparison with other countries in the region. According to the WHO Report on the Global Tobacco Epidemic 2025, health warnings on cigarette packages cover 85% in India, and 80% in Sri Lanka, while Pakistan remains at 60%. This regional comparison shows that Pakistan’s current 60% coverage is considerably below several neighboring countries. India, for example, requires 85%, while Nepal and Maldives require 90%. The WHO South-East Asia Region has also made substantial progress, with India, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste among countries achieving the highest level of achievement for large graphic health warnings in recent assessments.
Globally, the direction of tobacco packaging policy is similarly toward larger, more prominent and regularly rotated health warnings. Pakistan is stuck at its existing level of coverage, while international and regional experience shows a continued shift toward larger and more visible warnings. WHO identifies large, prominent pictorial health warnings, regular rotation, clear messaging and effective use of package space as key features of best-practice tobacco packaging policies. Countries such as Nepal, India and Sri Lanka have adopted substantially better health warnings on tobacco packages, demonstrating the growing regional emphasis on prominent health communication.
The effectiveness of GHWs depends greatly on how they are designed and displayed. Warnings that are large, clear, understandable and placed prominently on packaging are more likely to attract attention. Appropriate images can make complex health information easier to understand, while regularly changing or rotating warnings can help prevent people from becoming accustomed to the same message.
Pakistan therefore has an opportunity to build on the progress achieved in 2019. Moving beyond the current 60% coverage, introducing larger warnings to 85% and systematic rotation would bring the country’s packaging and labelling approach closer to the direction recommended by WHO FCTC and to standards increasingly seen across the region and globe.
Graphic Health Warnings are much more than pictures printed on cigarette packets. Pakistan should increase the mandatory coverage of graphic health warnings from 60% to at least 85% and establish a system for their regular rotation and updating. Raising coverage to 85% would represent a significant step forward in ensuring that health messages are more visible, prominent and effective, while bringing Pakistan closer to the standards already adopted by several countries in the region. They provide a voice to health consequences that are often hidden behind attractive packaging.
