What works best when it comes to reducing smoking rates – forcing cigarette makers to put their product in plain, drab packs with no branding, or plastering the packs with dire health warnings and ghastly photos of diseased organs and people with holes in their throats?

Australia is about to find out, being the first country to go the boring brown pack route. It will put to the test studies suggesting that smokers or would-be smokers find plain packs less appealing, and thus reduce consumption.

The plain packs are scheduled to hit the market in December, but the tobacco industry has mounted a legal challenge.

The Cancer Council of Australia welcomed the legislation, saying: “Documents obtained from the tobacco industry show how much the tobacco companies rely on pack design to attract new smokers.

“You only have to look at how desperate the tobacco companies are to stop plain packaging for confirmation that design is seen as critical to sales.”

With the drab packs and tax increases, the Australian government aims to bring down smoking rates from 20 percent in 2010 to less than 10 percent by 2018.

South Africa, meanwhile, is implementing regulations to compel cigarette manufacturers to add pictures of diseased lungs and mouth-and-throat cancers to written warnings on packs of cigarettes.

“Focus group research is being done to determine which images will work best in South Africa,” said Peter Ucko of the National Council Against Smoking.

Canada was the first country to introduce alarming images on its packs in 2000, followed by Brazil in 2002 and another 54 countries since.

The undramatic health warnings on packs of SA cigarettes are tame by international standards.

Originally, Canadian packs of cigarettes had to be 50 percent covered with health warnings and images, but since last month those warnings have to cover 75 percent of the pack area, with just a narrow strip at the bottom identifying the brand.

“Yes, the warnings have just got bigger,” said my Canadian cousin when I asked him about this while visiting the country a couple of weeks ago, but he was puffing away at the same rate, regardless.

About 20 percent of Canadians aged 12 and over smoke.

In SA, 22 percent of adults smoke, significantly down from 37 percent in the nineties, before smoking legislation arrived in 2000.

According to a new study published in the American Journal of Preventative Medicine, graphic warnings on cigarette packs are more likely to get smokers thinking about the health risks associated with their habit than packs with only text warnings.

The study of 200 smokers found that 83 percent remembered the health warning if it was accompanied by a graphic image such as a patient on a ventilator.

Only half of them accurately recalled the warning on text-only packs.

An example of a Canadian pack features a close-up photo of “Leroy” with his story: “I was diagnosed with cancer of the larynx when I was 48. I had to have my vocal cords removed and now I breathe through a hole in my throat.”

Another, clearly designed to shock younger smokers, has a photo of a young man being helped in a bathroom and the words: “A single stroke can leave you helpless.”

Dr Andrew Strasser, lead author of the study and associate professor at the department of psychiatry at the University of Pennsylvania School of Medicine, was quoted as saying the findings were important.

“In addition to showing the value of adding a graphic warning label, this research also provides valuable insight into how the warning labels may be effective, which may serve to create more effective warning labels in the future.”

consumer@knowler.co.za