Sri Lanka is unable to shoulder the high cost of treating patients with smoking related illnesses. “The tax income received from tobacco products are less than what government spend on these patients", Thero said

This tactic has been widely employed elsewhere in the world, but there have been repeated questions as to their effectiveness. Whilst they have been shown to deter more smokers than written warnings alone, their is increasing evidence that even the most shocking images do little to deter smokers.

The latest trend championed by anti-smoking activists is to insist that all tobacco product be sold in plain, unbranded packaging. The rise of e-cigarettes is also complicating matters, with regulations struggling to know how to classify the products. There is also the question that in Sri Lanka a large number of smokers buy their cigarettes individually over the counter, meaning that the warnings would have no effect whatsoever.