LAUSR

Smoking is a serious global health problem (and the leading cause of preventable death), currently causing nearly six million deaths every year from direct consumption or indirect exposure, of which one million occur in the Americas 1. Given this reality and the addictive nature of tobacco, public policies are needed to reduce (or eliminate) tobacco consumption, especially cigarettes 2,3. The World Health Organization (WHO) thus launched negotiations in the 1990s for the first multilateral treaty to protect the human right to health, through the Framework Convention on Tobacco Control (FCTC) 3, in force since February 27, 2005. A milestone in human rights that places the right to health above trade agreements and copyright treaties, the FCTC recommended a series of measures to reduce the demand for tobacco, especially by controlling consumption (i.e., education, addiction treatment), marketing (i.e., prices, taxes, content, packaging, advertising), and measures against exposure to tobacco smoke in society. Importantly, the FCTC also includes provisions on reduction of the tobacco supply, environmental protection, accountability issues, scientific and technical cooperation, and communication of information. The changes recommended by the FCTC include a ban on tobacco sales (especially cigarettes) in packaging that displays the company colors and logos associated with brands 3. These would be replaced by new packaging with standard dimensions in which the background would be a single color, with warning labels and images on the health risks from tobacco. The only carry-over from the old display would be the brand name, but always printed in the same font, color, and size, since cigarette and other tobacco product packages influence individual perception and are thus capable of “tricking” the products’ consumers 3. When the tobacco industry perceived the threat to one of its promotional tools, it launched a series of maneuvers against the adoption of plain packaging, arguing that the effectiveness of such changes had not been proven scientifically and that the change would have no real effect on tobacco consumption 4. In reaction to these maneuvers, a series of studies were conducted with smokers and non-smokers to investigate the psychological (i.e., perception), social (i.e., social appeal), and biological effect (i.e., neurological activation) of cigarette pack images on smoking prevalence and prevention. The aim of the current article is to present the results of these studies – and thus the scientific argument behind this specific provision in the FCTC that has motivated bills of law in Brazil and elsewhere in the world. Plain packaging of tobacco products in Brazil: the contribution of science to the decision to safeguard the human right to health