We need health warning labels on points of sale of fossil fuels

Mike Gill and colleagues explain how the implementation of fossil fuel labelling could have a significant impact on the awareness of climate change. This article is part of The BMJ’s Health in the Anthropocene collection. 

The use of fossil fuels should be rapidly reduced to keep the global mean temperature increase to well below 2°C above pre-industrial levels—a core goal of the Paris Agreement on climate change. Emphasising the risks to health of fossil fuel use, now and in the future, could motivate action.1

We propose a low cost, scalable intervention to facilitate change in individuals’ and society’s views and behaviour: warning labels at points of purchase of fossil energy or services dependent on large amounts of fossil fuel, for example at petrol stations, on energy bills, and on airline tickets. They should state clearly that continuing to burn fossil fuels worsens the climate emergency, with major projected health impacts increasing over time.2

Since 1969, increasing numbers of countries have required cigarette packets to carry health warnings.118 countries now require cigarette packets to include graphic pictures alongside stark health warnings.3 These warnings can change attitudes and behaviour, providing a critical contribution to effective tobacco control policy.4 Smoking is no longer viewed as a normal lifestyle choice, but as an addiction which harms the individual and those around them through exposure to second-hand smoke. Fossil fuel use also harms others through ambient air pollution that accounts for about 3.5 million premature deaths per year, as well as through climate change, which increasingly threatens the health of current and future generations.5

In many countries, fossil fuel use is already the subject of government intervention, through fuel and carbon taxes, vehicle emissions standards, and other legislation, but these are insufficient to prevent dangerous climate change and do not reflect the full economic costs of burning fossil fuels. Even if the nationally determined contributions for greenhouse gas emission reductions in the Paris Agreement are implemented, the global mean temperature increase is likely to exceed 3°C by the end of the century.6 For this reason there is growing acceptance that the world faces a climate emergency demanding urgent action at scale.

Nevertheless, vested interests continue to create doubt about the robustness of climate science, a cause of the inadequate scale and perceived urgency of investments in renewables.7 Other barriers to shifting consumer behaviours towards zero-carbon options include low awareness, habit, perceived cost, inconvenience, and “psychological distance”—the perception that the issue affects other people, places, or times, or is uncertain.8,9 Warning labels connect the abstract threat of the climate emergency with the use of fossil fuels in the here and now, drawing attention to the true cost of fossil fuels (the externalities), pictorially or quantitatively. They sensitise people to the consequences of their actions, representing nudges, designed to encourage users to choose alternatives to fossil fuels, thus increasing demand for zero-carbon renewable energy.

Implementing warnings will face challenges. For example, in North Vancouver, Canada, pictorial designs denoting biodiversity loss were ‘co-opted’ by the Canadian fuel industry and incorporated into a national ‘Smart fuelling’ initiative, with any threats to health omitted. In Sweden, eco-labels will be mandatory from this May. The labels will show ‘climate impact’, the raw materials used for the fuel, and their origin (see figure). They are part of a package to reduce fossil fuel use, including tax on new high emission cars and subsidy for low emission ones, but without direct reference to health. In contrast, Cambridge, Massachusetts voted in January to make information about the environmental and human health impact of fossil fuel use mandatory on all self-service fuel pumps. This explicit reference to health is likely to increase the labels’ effectiveness, because messages about the climate emergency framed around health tend to be more persuasive than environmentally framed messages.10

[Photo credit: “The Swedish Association of Green Motorists / Martin Prieto Beaulieu”]

Awareness of the need to take urgent action to reduce greenhouse gas emissions has recently increased. Introducing warning labels, framed as a health warning, could therefore be timely. The labels could use a grading system according to the estimated greenhouse gas emissions. Labelling should be culturally tailored, and informed by public consultations. This would, for example, take into account the needs of low and middle-income nations, such as the potential to use gas as a transitional fuel until zero-carbon alternatives become affordable to replace household solid fuels, thus reducing air pollution in countries such as India. The initial focus should be on high income nations that have contributed disproportionately to greenhouse gas emissions and on major sources of greenhouse gas emissions in emerging economies where they are rising rapidly. 

Part of the shift in attitudes towards tobacco use was a result of increasing stigma around smoking. It is now generally viewed as antisocial. At the same time, the cost of smoking significantly increased, TV cigarette commercials were banned, and television and film dramas were discouraged from associating smoking with sophistication and sexual allure. To address fossil fuel use additional policies could include increasing restrictions on advertising by fossil fuel companies, particularly to prevent misleading claims about investments in renewable energy when these represent a minority of their portfolio. 

Although individual action alone is insufficient to achieve the aims of the Paris Agreement, it is critical. Governments should take urgent, decisive steps to raise awareness of personal choices that reduce greenhouse gas emissions as well as implementing national policies to decarbonise the economy. Individual exposures to the proposed warning labels will be most frequent for those who use most fossil fuels, thus having a potentially larger impact on those individuals who are disproportionately contributing to the climate emergency. 

There is an opportunity for national and local governments to implement labelling of fossil fuels in the run-up to COP26 in Glasgow, and in particular for the UK Government, as the host of the COP, to show leadership, as part of a package of measures to accelerate progress on getting to ‘Net Zero’ emissions. When the covid -19 pandemic eventually wanes, labelling could play an important role in helping to reduce the risk of a rapid rebound in GHG emissions as the economy expands.

(We acknowledge the contributions of James Brooks of the organisation “Think Beyond the Pump” in co-writing the op-ed, “‘Warming’ labels needed at the gas pump”)

Mike Gill, former Regional Director of Public Health, South East England.

Kristie L. Ebi, Professor of Global Health, Center for Health and the Global Environment, University of Washington, USA.

Kirk R. Smith, Professor of Global Environmental Health, School of Public Health, University of California, Berkeley, USA; Director, Collaborative Clean Air Policy Centre, India.

Lorraine Whitmarsh, Professor of Environmental Psychology, Centre for Climate Change & Social Transformations, School of Psychology, Cardiff University, UK.

Andy Haines, Professor of Environmental Change and Public Health, Centre for Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, UK.

Competing interests: None declared


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