Government and anti-smoking campaigners’ efforts to deter youngsters from beginning to smoke or carrying on the habit if they already do, have been dealt a major blow this week after a new study suggests that the picture and text warnings on the back of cigarette packets have little impact on teenage smokers. Research published online in the journal Tobacco Control says that despite images such as those showing diseased lungs and tumours being quite effective at deterring young people from smoking in comparison to text warnings, they are usually printed on the back of cigarette packets. This therefore lessens their visibility and effectiveness. The research in Tobacco Control  was led by Dr Crawford Moodie from Stirling’s Centre for Tobacco Control Research at the University of Stirling and is based on two surveys – the first comprising of over 1,000 11 to 16-year-olds in the UK in 2008 and a second survey which quizzed a further 1,000 in 2011. Questions included in the survey were designed to look at how effective the visibility and impact of the warnings on packs were, in addition whether or not they were easy to understand, believable, and exactly how persuasive they were. The majority of the teenagers questioned in both surveys (68% to 75%) claimed they had never smoked a cigarette, 17% to 22% had ‘experimented’ with cigarettes, whilst approximately one in 10 of the teenagers were alarmingly already regular smokers. This was defined as smoking at least one cigarette every week. Half of the teenagers in both of the surveys had either ‘often’ or ‘very often’ spotted the warnings on cigarette packs, and roughly one in five had read them very often or had studied them closely. The number of teenagers who said the warnings had deterred them from smoking had risen between the two surveys, but not amongst those who regularly smoked. For regular smokers, where the warnings on cigarette packets had put them off having a cigarette, there was drop in the proportion of teens from 32% to 23%. The ability to recollect pictures on the packets showing diseased lungs, rotten teeth and neck cancer, stood at a pitiful 10% and three text warnings on the back of packs that did not include any supporting images were only remembered by under 1% in both surveys. The study authors comment: “As warnings need to be salient to be effective, positioning pictorial warnings only on the less visible reverse panel limits their impact.” Back in 2008, the UK became the third European Union country to print pictorial health warnings to on the backs of cigarette packets, in an attempt to urge more people to stop smoking. However, in the subsequent five years, it appears the same images are not having the same effect. In fact, five years of the same images may have led to a ‘wear out’ factor, particularly amongst those who smoke often. “Positioning pictorial warnings only on the back of packs may have had a deterrent effect on never and experimental smokers, but for most measures no significant differences were observed. The impact on regular smokers was negligible,” the authors added. Deborah Arnott, chief executive of health charity Action on Smoking and Health (ASH), said: “The evidence is clear: warnings on cigarette packs help deter young people from taking up smoking, and the larger and more graphic they are the better. However, to be really effective, picture warnings need to be on the front of the packs. Currently the EU doesn't allow this but next week the European Parliament is due to vote on a directive which will require larger picture warnings on the front of all cigarette packs. The tobacco industry is lobbying hard against this. ASH urges MEPs not to let the tobacco industry succeed in its multimillion- pound campaign to delay the vote and derail the directive.”