Variation in health warning effectiveness on cigarette packs: a need for regulation?

The Tobacco Products Directive allows the possibility of strategic placement of health warnings on cigarette packs by manufacturers to reduce overall warning effectiveness. Information regarding health warning effectiveness was assessed in an online survey, and the prevalence of warnings on cigarette packs was assessed in a shop survey. Although we find no evidence of a strong correlation between health warning effectiveness ratings and their frequency on cigarette packs (r = −0.17, P = 0.56), there may be other ways this possibility is exploited. We suggest that this potential loophole is addressed and monitoring of the placement of health warnings on cigarette packs is continued.