Shocking images showing the effects of smoking will be printed on cigarette packets sold in local shops from the middle of next year.

The warnings will underline the increased risks of cardiovascular disease, cancer, infertility and impotence among smokers, and the harm done to unborn babies and children.

Three in every four Europeans have said they support picture health warnings on cigarette packs, according to a Eurobarometer survey.

Speaking at a press conference to mark No Tobacco Day yesterday, Health Promotion and Disease Prevention Department head Charmaine Gauci said there were 372 deaths attributable to smoking in 2008.

These included lung, trachea and bronchus cancers, heart disease and stroke as well as chronic bronchitis.

Despite the dangers, a fifth of respondents in the last Health Interview Survey, carried out in Malta in 2008, said they had smoked daily for at least a year. Smoking was most common among 45- to 54-year-olds.

A quarter of those interviewed, aged 18 and over, said they were still exposed to second-hand smoke, either at home or outside, despite a ban on smoking in public places introduced in 2004. Health Minister Joe Cassar said smoking in bars and other public places was a sign of disrespect towards others. "We do not need to enforce any law if we all showed respect," he said.

Dr Cassar said 1.3 million people around the world smoked and every year 4.9 million people died as a result. "Half of smokers risk dying because of smoking-related illness," he said.

He said health professionals were duty-bound to inform people about the dangers associated with smoking. Research had shown that even a short intervention by health professionals could be very effective in helping people stop smoking.

Dr Cassar said that, apart from one-to-one help, professionals could also help on a community level by preparing plans in support of smoking regulations in public places and help smokers kick the habit.

"Professionals should serve as a model and the Health Department is helping them to stop smoking," he said. Health care workers were also given courses allowing them to help others quit smoking.

He said restrictions on smoking in public places had helped more people quit smoking, and other countries were adopting similar laws.

The Health Department yesterday announced the three winners of its biannual Quit And Win Competition. Joseph Magro, 34, Reuben Hayman, 23, and Claudine Psaila, 41, managed to stop smoking.