FDA unveils graphic cigarette warning labels

Cigarette packages will soon be splashed with horror-movie-style warning labels showing corpses, diseased lungs, and rotted teeth, which were unveiled by the US Food and Drug Administration on Tuesday morning. By September 2012, cigarette manufacturers will be required to place an equal assortment of the nine new images across the top half of their packages with large-type warnings stating that “smoking can kill you” or “cigarettes are addictive”.

The new images will replace the small white warning boxes that have adorned cigarette packages unchanged for more than two decades; they’re required under a federal law passed in 2009 that gave the FDA regulatory authority over cigarettes. The same new warnings will appear on print ads and must comprise at least 20 percent of the ad space.

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“The new graphic warnings will make a powerful difference,” FDA commissioner Dr. Margaret Hamburg said in an interview. “Research demonstrates that they encourage smokers to quit and nonsmokers to not start.”

Packages will also contain the 1-800-QUIT-NOW toll-free telephone number, she added, to provide smokers with a resource to help them quit.

Some 43 countries, including Canada, Great Britain, and Israel, already require large graphic warnings on cigarette packages, and a European Union directive gives its 27 member countries the option of adding pictures to warnings as a way to educate smokers about risks.

A 2006 study found that two-thirds of smokers in four countries that have graphic warning labels reported that the package was an important source of health information and strongly associated with an intention to quit smoking.

Matthew Myers, president of the nonprofit advocacy group Campaign for Tobacco Free Kids, tells me that the graphic warnings “counter images that the tobacco industry is seeking to project—that smoking makes a person strong, cool, and independent.” And, he added, there’s no evidence that young smokers will rebel against such strong warnings in a backlash against too much government intervention.

“That’s a myth that the tobacco industry seeks to promote,” said Myers, “because they know how effective the strongest labels are.”

Indeed, one can clearly see the consequences of a smoking-induced heart attack in the face of a man lying with his tie askew, whose nose and mouth are covered with an oxygen mask. And while warning labels will no longer mention the lung disease, emphysema, we can see its devastating effects through smoke seeping out of a tracheotomy hole in a smoker’s neck.

Cigarette manufacturers are challenging the legality of the new labels in a federal lawsuit and say the size of the new warnings make the company brands “difficult, if not impossible, to see.” They claim the law that was passed by Congress violates their right to free speech. A spokesperson for Atria, which owns Philip Morris, said in an email that the company is reviewing the images released this morning but made no further comment.

Myers, who as a federal worker 30 years ago helped implement the current boxed warnings, said they had long ago lost their effectiveness. “They’re barely visible on the package and not eye catching,” he says, and consumers largely ignore them now. “Even the strongest message needs to be refreshed periodically.”

Before selecting the nine images, the FDA conducted studies involving 18,000 participants—including children, pregnant women, and seniors—to determine which graphics had the most powerful effects, said Hamburg. The agency will continue to conduct focus groups in the months and years ahead to monitor any waning of the images’ impact and will rotate in new ones when necessary.

Nearly half a million people still die every year of smoking-related causes, and half of the estimated 47 million smokers in the United States today are expected to die prematurely as a result of their habit.

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