Graphic cigarette labels meet with mixed reviews

Tuesday, June 21, 2011 | 5:55 p.m. CDT; updated 2:11 p.m. CDT, Sunday, July 24, 2011
This image provided by the U.S. Food and Drug Administration on Tuesday shows one of nine new warning labels cigarette makers will have to use by fall 2012. In the most significant change to U.S. cigarette packs in 25 years, the FDA's the new warning labels depict in graphic detail the negative health effects of tobacco use.

RICHMOND, Va. — Rotting teeth. Diseased lungs. A corpse of a smoker.

Nine new warning labels featuring graphic images that convey the dangers of smoking will be required by the Food and Drug Administration to be on U.S. cigarette packs by 2012. Other images include a man with a tracheotomy smoking and a mother holding a baby with smoking swirling around them. The labels will include phrases like "Smoking can kill you" and "Cigarettes cause cancer".

The labels, which the FDA released Tuesday, are a part of the most significant change to U.S. cigarette packs in 25 years. They're aimed at curbing tobacco use, which is responsible for about 443,000 deaths in the U.S. per year.

The labels will take up the top half of the front and back of each  pack of cigarettes, and each will include a number for a national quit-smoking hotline. Warning labels also must appear in advertisements and constitute 20 percent of an ad. Cigarette makers have until the fall of 2012 to comply.

"These kind of graphic warning labels strengthen the understanding of people about the health risks of smoking," FDA Commissioner Margaret Hamburg said in an interview with The Associated Press. "We clearly have to renew a national conversation around these issues and enhance awareness."

Mandates to introduce new graphic warning labels were part of a law passed in 2009 that, for the first time, gave the federal government authority to regulate tobacco, including setting guidelines for marketing and labeling, banning certain products and limiting nicotine. The announcement follows reviews of scientific literature, public comments and results from an FDA-contracted study of 36 labels proposed last November.

The legality of the new labels also is part of a pending federal lawsuit filed by Winston-Salem, N.C.-based Reynolds American Inc., parent company of America's second-largest cigarette maker, R.J. Reynolds; No. 3 cigarette maker, Greensboro, N.C.-based Lorillard Inc.; and others.

Tobacco makers involved in the lawsuit have argued the warnings would relegate the companies' brands to the bottom half of the cigarette packaging, making them "difficult, if not impossible, to see."

A spokesman for Richmond, Va.-based Altria Group Inc., parent company of the nation's largest cigarette maker, Philip Morris USA, said the company was looking at the final labels but would not comment further.

In recent years, more than 30 countries or jurisdictions have introduced labels similar to those being introduced by the FDA. The U.S. first mandated the use of warning labels stating "Cigarettes may be hazardous to your health" in 1965. Current warning labels — a small box with black and white text — were put on cigarette packs in the mid-1980s.

The FDA said the new labels will "clearly and effectively convey the health risks of smoking" aimed at encouraging current smokers to quit and discouraging nonsmokers and youth from starting to use cigarettes.

"These labels are frank, honest and powerful depictions of the health risks of smoking," Health and Human Services Secretary Kathleen Sebelius said in a statement.

American Cancer Society CEO John R. Seffrin applauded the new labels in a statement, saying they have the potential to "encourage adults to give up their deadly addiction to cigarettes and deter children from starting in the first place."

The new labels come as the share of Americans who smoke has fallen dramatically since 1970, from nearly 40 percent to about 20 percent. The rate has stalled since about 2004. Around 46 million adults in the U.S. smoke cigarettes.

It's unclear why declines in smoking have stalled. Some experts have cited tobacco company discount coupons on cigarettes or lack of funding for programs to discourage smoking or to help smokers quit as possible reasons.

While it is impossible to say how many people quit because of the labels, various studies suggest the labels do spur people to quit. The new labels offer the opportunity for a pack-a-day smoker to see graphic warnings on the dangers of cigarettes more than 7,000 times per year.

The FDA estimated the new labels will reduce the number of smokers by 213,000 in 2013, with smaller additional reductions through 2031.

Tobacco use costs the U.S. economy nearly $200 billion annually in medical costs and lost productivity, the FDA said. Tobacco companies spend about $12.5 billion annually on cigarette advertising and promotion, according to the latest data from the Federal Trade Commission.

The World Health Organization said in a survey done in countries with graphic warning labels that a majority of smokers noticed the warnings and more than 25 percent said the warnings led them to consider quitting.

While some have voiced concerns over the hard-hitting nature of some of the labels, those concerns should be trumped by the government's responsibility to warn people about the dangers of smoking, said David Hammond, a health behavior researcher at the University of Waterloo in Canada who worked with the firm designing the labels for the FDA.

"This isn't about doing what's pleasant for people. It's about fulfilling the government's mandate if they're going to allow these things to be sold," Hammond said. "What's bothering people is the risk associated with their behavior, not the warnings themselves."

In places like Canada, Hammond said smokers offended by some of the images on cigarettes packs started asking for different packs when they received ones with certain gory images or used a case to cover them up. But smokers said those warnings still had an effect on them.

Canada introduced similar warning labels in 2000. Since then, the country's smoking rates have declined from about 26 percent to about 20 percent. How much the warnings contributed to the decline is unclear because the country also implemented other tobacco control efforts.


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Doug Carter June 21, 2011 | 6:56 p.m.

I believe it's stupid and a waste of time and money to do this. People know what harm smoking can do, they will have to make their own choice to quit or not quit. I am a smoker and am really tired of non-smokers trying to persuade us to quit. Thanks for wasting our time and money with more nonsense.

(Report Comment)
frank christian June 21, 2011 | 8:57 p.m.

This isn't about health, or, stopping folks from smoking tobacco. Joe Califano, Carters HEW Cabinet Sec. first spent 33M$ for printed cigarette warnings. Got fired for some reason. That didn't help, so, TV movie actor/director,"meat head" Rob Reiner, from Archie fame, lobbied and got a California bill passed, for 150M$ for commercials to prevent smoking by adult human beings. Do we wonder who directed the ads? David Axelrod, was given control of 150M$, before leaving WH for communication assistance with "stimulus" program.

Whom, might we imagine, will be producing these health protecting, new warnings?

(Report Comment)
James Herring June 22, 2011 | 11:19 a.m.

I am not a smoker. Never have, never will. But I don't care for these ads. When did government start getting into business advertising? Thats right. Right after they got into the automotive industry.

What happened to free speech? Ok, I can understand pulling offensive or obscene ads. But to me this is targeting advertising. Like when they went after the camel. Like they are trying to get rid of Ronald McDonald. Effective ads is something the government can't control.

Even though I don't smoke, won't smoke, I don't like these ads. Part may be the images, but the other and bigger part is that they were TOLD to do it by the government. Like its the government's responsibility to warn people about the dangers of smoking. I think the government needs to worry about the government. or is this a 'smoke screen' to keep us from wondering when they are going to fix the things they promised. Or a myriad of other things. Don;t get me wrong, I am glad that they are stepping up a campaign to make people aware of cancer. But when you start telling private businesses what to do, THAT I don't agree. I am now waiting to see warning labels on Crispy Creme donuts. Are we going to just put pictures of fat people on the boxes? Don't we take responsibility for our actions any more?

Most smokers I know aren't going to suddenly see these images and think, "Oh my gosh! I need to stop smoking!" Maybe they should raise the cigarette tax. Oh wait, they did that already. Maybe they should pass ordinances against smoking outside in a park. Didn't New York just do that?

First they came for the smokers,
and I didn't speak up because I wasn't a smoker...

just my opinion...

(Report Comment)
Mark Foecking June 22, 2011 | 11:30 a.m.

"The World Health Organization said in a survey done in countries with graphic warning labels that a majority of smokers noticed the warnings and more than 25 percent said the warnings led them to consider quitting."

I don't know of a smoker that doesn't consider quitting. However, I doubt these images will have that much of an effect. What smoker doesn't know it's not bad for them?


(Report Comment)
Paul Allaire June 22, 2011 | 11:49 a.m.

I can't believe you all. They should have done it a long time ago.

(Report Comment)
Kevin Gamble June 22, 2011 | 1:03 p.m.

James, I understand your intent, but I think you use the "First they came for..." quote too lightly here. These are simply warning labels on products which are not in any way essential for survival. No one's being prevented from smoking.

As for the idea that smokers' rights to smoke are being infringed on by laws, what really gives a smoker the right to smoke around anyone else, to begin with? Smokers' rights end where my rights begin, which is the right to control what goes into my body - the same right that smokers claim, and the right they should thus respect in others. It's no more non-smokers' responsibility to move away from smoke than it is residents' responsibility to move out of a neighborhood being polluted by toxic wastes from an industrial plant. Laws are in place to prevent some from doing harm to others.

To me, the free-speech rights of corporations mean comparatively very little. I place them below the basic human rights and freedoms of any individual, and below the individual's right to shape the basic principles of society through collective action - otherwise known as government. Corporations exist at the discretion of individuals, and their rights go as far as allowed by real, living humans. They are less than real human individuals, and should always be treated as such.

(Report Comment)
Ryan Cornell June 22, 2011 | 2:01 p.m.

If I was still a smoker, I might actually buy more packs just to collect them all.

(Report Comment)
hank ottinger June 22, 2011 | 2:20 p.m.

Mark writes, ". However, I doubt these images will have that much of an effect. What smoker doesn't know it's not bad for them?"

According to the article, such labels have an effect on Canadian smokers' habits.

Mr. Herring decries government intrusion, yet it is often "the government" that will pick up the health tab for smokers who put a disproportionate burden on the system, given that the habit contributes to (or even causes) cancer and pulmonary disorders like COPD, the fourth largest cause of death in the US.

(Report Comment)
Ellis Smith June 22, 2011 | 2:43 p.m.

Mandated product warning labels have been with us for some years. Not all are federal.

As you would surmise, most of these labels apply to the PRODUCT, but not in all cases. For example, there's what's called the "California Child Drowning" label, which must appear conspicuously on every metal or plastic pail above a certain size for products (supplied in pails) sold in the state of California.

What's that about? Well, if one of the EMPTY (product has been used) pails gets water or some other liquid in it, a small child might DROWN in it! No, folks, I am not making this up.

I can tell you special state requirements cause problems for manufacturers that sell their products nationally. It is cost-ineffective for the manufacturer to inventory pails labeled for just one state, so the alternative is to put the California label on ALL pails, no matter where the product is shipped.

Welcome to the 21st century! I'd like to see some statistics as to how many small children drown annually in used metal or plastic pails.

In my experience there is another problem with having a large number of warning labels: people will actually LOOK at a few labels, but less so when there are lots of labels.

(Report Comment)
Mark Foecking June 22, 2011 | 2:58 p.m.

Actually I just sat down and looked at all of them (I didn't look at the other pictures before), and I thought they were rather mild compared to what they could have done.

Remember those metal cases that people used to keep soft packs in before they came out with hard packs? Maybe there's a business opportunity here. :)


(Report Comment)
Robin Nuttall June 22, 2011 | 3:52 p.m.

If it's being shown that the new labels are helping convince some people to quit, I say go for it.

As for smokers all "knowing they should quit," I beg to disagree. I know a fairly alarming number of smokers who cling with desperate intensity to the pseudoscience that says smoking is not harmful. They do not want to hear that they are killing themselves so use any excuse, even lies, to try to justify their habit.

Smoking is a gross, disgusting, addictive habit. Nicotine is an addictive drug. Smoking will kill you. Even if it doesn't kill you, it will make you look older, cause innumerable other not-immediately-fatal health issues, make you stink, make your clothes, car and home stink, make your loved ones ill. Make strangers ill, if you smoke around them. Please. Quit smoking.

(Report Comment)
Mark Foecking June 23, 2011 | 12:32 p.m.

Robin Nuttall wrote:

"I know a fairly alarming number of smokers who cling with desperate intensity to the pseudoscience that says smoking is not harmful."

I don't (every smoker I know wishes they could quit, and many have tried to several times), but I think it's more that smoking is not harmful for a period of years to decades that makes people think "it won't happen to them".

On average, it takes 15 to 20 years of a pack a day habit (15-20 pack-years) before the usual smoker's diseases become significant. Even in lifetime smokers, the risk of lung cancer is only about 1 in 6. There is a significant minority of smokers that don't get significant COPD either, despite 40 and 50 pack-year habits.

I agree that smoking is a thing no one should do, and we should always draw attention to the fact it does risk people's health. I just don't agree that we haven't done that enough with current warnings and taxes.


(Report Comment)
Anne Christnovich July 1, 2011 | 2:50 p.m.

"Quit line calls spike after cigarette labels debut" -- article from the Associated Press

Anne Christnovich

(Report Comment)

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