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2018 年 8 月 15 日
Mr. Taro Aso, Minister of Finance
Mr. Akishi Kosakada, Tobacco and Salt Business Manager, Bureau of General Affairs, Ministry ofFinance
Mr. Takashi Igarashi, Committee Chairperson, Tobacco Businesses Subcommittee; Board Chairperson,
National Center for Health and Development
Mr. Takashi Kadowaki, Interim Committee Member, Full-time Visiting Professor, Teikyo University,
August 15, 2018

Please replace the health warnings on tobacco packages with the images set by international
standards.
Sakuta Manabu, Chairperson, General incorporated association Japan Society for Tobacco Control
Heretofore, on 30 November 2015, 15 January 2016 and other dates, the Japan Society for
Tobacco Control as an independent society and together with committees aiming to limit passive
smoking (with 103 other domestic organizations) have asked to revise the health warnings ontobacco packages (packs, cartons and other containers) according to international standards.
I humbly ask this time again.	  Tobacco (with nicotine) has greater addictiveness than cannabis or stimulants1). Without
knowing tobacco is dangerous, many people have handed it out, continue to smoke from addiction,and tragically shorten their lives1). Health warnings on tobacco packages together with increased
tobacco taxes are considered good measures to remedy this situation.
1) Nutt D, et al. Development of a rational scale to assess the harm of drugs of potential misuse. Lancet
369:1047-53,2007.

Chronicle① According to the Framework Convention on Tobacco Control (FCTC), more than 100
countries around the world are adopting images that convey health warnings, and our country
should also abide by this international standard. (Figure ①)
Regarding images that convey health warnings, the guidelines are stipulated as follows.
Guideline 14
Article 11 (1) paragraph (b) (v) advises that the packages and labels of tobacco products
regarding health warnings and messages be displayed using illustrations and photographs.

Research has shown that health warnings that contain images in addition to written statements aremuch more effective compared those with only written statements.
Also, warnings that include images can be expected to be effective for those with low literacy andeven for those who do not understand the displayed language. When signatory nations regulate
packages and labels of tobacco products, they should use health warnings with culturally
appropriate images that use multicolored printing. They should also consider publishing warnings
with images on multiple main surfaces of tobacco packages.
Guideline 15
Research has shown that health warnings that display only written statements are less effective
compared those with both written statements and photos. Health warnings with both• attract more attention• have a greater influence on smokers• have an influence that lasts longer• more clearly convey the risks of health damages from using tobacco• increase awareness of health damages from tobacco more and motivate people to quit
smoking more
• enhance the intention and ability to quit smoking• increase the frequency of attempts to quit smoking
Guideline 16
Health warnings and messages that use images are likely to reduce the brand image of tobacco
packages and its appeal.	 
Accordingly, as for our country approving and establishing guideline 14,
I advise that that the packages and labels of tobacco products regarding health warnings andmessages be displayed using illustrations and photographs. Research has shown that healthwarnings that contain images in addition to written statements are much more effective comparedthose with only written statements.
“Also, warnings that include images can be expected to be effective for those with low literacy andeven for those who do not understand the displayed language. When signatory nations regulate
packages and labels of tobacco products, they should use health warnings with culturally
appropriate images that use multicolored printing.”
Accordingly, it is advisable to display health warnings that use illustrations and photographs, andthis is also much more effective compared to the case with only written statements.
Also, warnings that include images can be expected to be effective for those with low literacy
and even for those who do not understand the displayed language, and when minors start toexperiment with smoking tobacco, I expect the images to create an inhibiting effect.

図①
Figure ①②

Please make the surface area of the images at least 50%, not less than 30% as it iscurrently.

Even though our country has ratified the convention agreement, it has not enforced the guidelines,
and the surface area for health warnings remains less than 30% of the total.
The guidelines of Article 11 of the FCTC, which our country has approved, have determined thedetails of displaying which images at what percentage of the total surface area.
Guideline 12
Convention Article 11 (1) (b) (iv) advises that the warnings of health damage and othermessages on the packages of tobacco products should cover at least 50% of the main surface areaand not less than 30% of main surface area.
Evidence from research has shown that the effectiveness of health warnings and other messages
increases with the size of the display. Parties to the convention should consider stipulating that thehealth warnings on the main surfaces of tobacco product packages should be at least 50% of thatarea and should occupy the largest possible area. Furthermore, the display of health warnings
should be in bold and highly distinctive colors and should use designs and colors that are easy to
see and to read in a font size with high visibility.

Guideline 13
When calculating the proportion that health warnings should occupy of the whole display surface,
if a borderline to enclose the health warnings is needed, the ratifying country will consider
excluding its area from the area that is used for the health warning according to the framework
convention. In other words, for the area that is used according to the framework convention, only
the health warnings will be calculated for the proportion of the whole, and the borderline should not
be included in representing the area of the warning itself.
In sum, the display area of the health warnings in Japan has currently not reached what FCTC has
hoped to attain, and it should consider ending the violation of that international convention for thefuture.
③ Several countries have already determined the design of about 10 plain packages, and ourcountry should also follow these designs. (Figure 2)
For guideline 46, plain packaging is written as follows.
Guideline 46“Parties to the convention will consider ways to encourage standard colors and designs that restrictor prohibit the use of logos, colors, brand images and promotional information with plain packaging.
This can enhance the visibility and effectiveness of health warnings. Plain packaging avoids
distracting attention from health warnings and prevents packages with commercial designs that canimply that certain products are safer than others.
Plain packaging is not mandatory, but is recommended.
Plain packaging avoids distracting attention from health warnings and prevents packages withcommercial designs that can imply that certain products are safer than others. For example,
whenever a cigarette is slender, then governments may need to regulate the possible implication that
if you smoke cigarettes, then you can lose weight.
Furthermore, in many countries like Thailand, Korea, Russia, the United Kingdom and Australia;
tobacco displayed at stores and exhibitions is prohibited; advertising that promotes selling is also
prohibited. Because traditional tobacco packages themselves effectively become advertisements,
plain packages can prevent this kind of advertising.	 

This is the end.
Figure ③ Australia, 2017