Graphic images aimed at cutting US tobacco use

CORPSES, cancer patients and diseased lungs: These are some of the images the US federal government plans for larger, graphic warning labels for cigarette packages.

The images are part of a new push announced by the Food and Drug Administration and the Department of Health and Human Services yesterday to reduce tobacco use, which is responsible for about 443,000 deaths per year.

The United States was the first country to require that tobacco products carry health warnings, and all cigarette packages now sold in the United States have modest and widely ignored messages, like “Surgeon General’s Warning: Smoking Causes Lung Cancer, Heart Disease, Emphysema, and May Complicate Pregnancy.”

A growing number of countries, excluding Ireland, have gone well beyond such brief warnings, though, and now require large, graphic depictions of smoking’s effects.

The number of Americans who smoke has fallen dramatically over the past 40 years, but those declines have stalled recently. About 46 million adults in the US, or 20.6%, smoke cigarettes, along with 19.5% of high school students.

The new prevention plan is part of the law passed in June 2009 giving the FDA authority to regulate tobacco, including marketing and labelling guidelines, banning certain products and limiting nicotine. The law doesn’t let the FDA ban nicotine or tobacco entirely.

“Today, FDA takes a crucial step toward reducing the tremendous toll of illness and death caused by tobacco use by proposing to dramatically change how cigarette packages and advertising look in this country,” FDA commissioner Margaret Hamburg said in a news release.

“The health consequences of smoking will be obvious every time someone picks up a pack of cigarettes.”

The FDA is proposing 36 labels for public comment, which include phrases like “smoking can kill you” and “cigarettes cause cancer”, but also feature graphic images to convey the dangers of tobacco use.

The agency will select the final labels in June after reviews of scientific literature, public comments, and results from an 18,000-person study. Cigarette makers will then have 15 months to start using the new labels.

The new warning labels are to take up half of a pack – both front and back – of cigarettes and contain “colour graphics depicting the negative health consequences.”

Warning labels also must constitute 20% of advertisements.

“It acts as a very public billboard because you all of a sudden are reading something about lung cancer from that pack behind the cash register, whereas before you were just reading Marlboro,” said David Hammond, a health behaviour researcher at the University of Waterloo in Canada.

He is working with the firm designing the labels with for the FDA.

In recent years, several countries have introduced labels similar to those proposed by the FDA.

While it is impossible to say how many people quit because of the labels that have been introduced in several countries, Hammond said every source of evidence suggests that the labels do help people quit.

Given the population in the US, the impact of the warning labels could be “significant”, Hammond said.

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