Tobacco industry's global strategies to block diffusion of health warning labels

Objective: To analyze multinational tobacco companies strategies to block diffusion of health warnings on cigarette packs.

Methods: Analysis of global warning label practices and tobacco industry documents.

Results: Health warning labels, especially labels with graphic element, are threatening to the tobacco industry because they offer low cost and effective measure to reduce smoking. Multinational tobacco companies did not originally object to innocuous warnings with blurred health message. The companies began to cooperate in undermining warnings once more lucid warnings began to appear since the 1970's. At critical junctures where new health warning label innovations have been introduced, multinational companies have been adamant to defend the integrity of the pack as a marketing tool and used methods such as export embargos to pursue this target. Since 1985, the tobacco industry has been aware of the effectiveness of graphic health warning labels (GWHL). The industry launched an all out attack on Sweden in 1991 to prevent the introduction of GHWLs, and was successful in delaying GHWLs internationally for nearly ten years. Conclusion: More concentrated efforts from the tobacco control community are called for to subvert tobacco industry lobbying efforts and introduce GHWLs also in developing countries.