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Combined anti-smoking warnings: is a canton level approach for languages required?


Diane O Doherty, Frank Houghton, Derek McInerney, Sharon Houghton, Bruce Ducan


“It’s attention to detail that makes the difference between average and stunning.”

Francis Atterbury [1]

Tobacco use is the world’s leading cause of preventable mortality and morbidity [2]. Switzerland is no exception, with a death toll attributable to tobacco-induced illness of over 8600 per annum [3]. The direct and indirect financial costs of smoking in Switzerland are estimated to be 10,063 million Swiss Francs per annum [3]. Although the generally accepted adult smoking rate in Switzerland is, at 26.9%, below average for a country that scores highly on the Human Development Index (HDI) [3], it has been suggested that this figure may be a significant underestimate, with the true figure being 31% [4].

Switzerland’s tobacco control laws are comparatively lax by European Union standards [5], and although a signatory to the WHO Framework Convention on Tobacco Control, Switzerland has not ratified the treaty. In addition, the cost of a packet of cigarettes in Switzerland is relatively low in West European terms [6]. There is a substantial body of evidence suggesting that anti-smoking warnings on tobacco products are important in tobacco cessation [8]. Research suggests that although the graphic images are important, the significance of the text should not be underestimated [7]. Given that there currently appears to be little appetite for a more comprehensive tobacco advertising ban in Switzerland, it may be opportune to fine-tune and improve current antis-moking warnings on tobacco products.

Emerging evidence [8, 9] suggests that one improvement that should increase the effectiveness of current combined anti-smoking warnings is to prioritise the language order of the text warnings based on regional linguistic patterns. At present, Swiss legislation specifically mandates the language order of the text in the combined graphic and text warnings: “in all official languages and in this order: German, French and Italian”.

Although the prescribed order of German, followed by French and then Italian reflects relative linguistic dominance at the national level, there is clear spatial differentiation in language use within Switzerland. This factor is important, given the importance of the self-referential element in anti-tobacco warnings [10, 11] and the critical need in all forms of advertising for absolute brevity given very limited attention time [12]. Therefore, a more spatially disaggregated model is suggested. Given the historical and cultural importance of Cantons within Federal Switzerland this suggestion should be acceptable to most, with the obvious exception of the tobacco industry and their representatives.

Although German should be used as the first language on the combined anti-smoking warnings in most Cantons, the order should be changed for tobacco products sold in Fribourg, Genève, Jura, Neuchâtel, Vaud and Valais, so that French appears first. Similarly, in Ticino Italian should come first. The populations living in these Cantons are not insignificant. The six Cantons with French as their official first language include a population of approximately 1.8 million. The population in Ticino at over 300,000 is not dramatically different from that of either Luxembourg or Malta, countries that both require tailored anti-smoking warnings (French and German in Luxembourg, English and Maltese in Malta).

Current tobacco control legislation in Switzerland is based on a “one-size-fits-all” approach in linguistic terms. Federal legislation mandates the order of the warnings to appear in German, then French, and lastly Italian. This is inappropriate given that there are seven Cantons with a total population in excess of two million where German is neither the official language, nor the primary language of the vast majority of the population. A more focused regional approach to language is proposed. German should come first in tobacco warnings in 19 Cantons, French in 6 Cantons and Italian in the Canton of Ticino. This approach has additional advantages in that it is effectively cost free to the State, and simply refines existing provision, rather than advocating new measures which may be disputed and defeated.



This research was supported by the Graduate and Research Office at Limerick Institute of Technology via a PhD student stipend.


Authors declare no conflict of interest.


Diane O Doherty: Limerick Institute of Technology, Limerick, Ireland

Frank Houghton: Limerick Institute of Technology, Limerick, Ireland

Derek McInerney: Limerick Institute of Technology, Limerick, Ireland

Sharon Houghton: University of Limerick, Limerick, Ireland

Bruce Ducan: Gisborne, New Zealand


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