The U.S. government will require grim new warning labels on all cigaratte… (U.S. Food and Drug Administration )
With the unveiling of nine graphic images that will adorn every cigarette pack sold in the U.S. starting in fall 2012, government officials and outside experts predict there will be an initial wave of smokers who seek help in quitting. But they caution that regulators will have to refresh — and possibly dial up — their message so that consumers don't grow complacent about the omnipresent warnings.
The graphic labels released Tuesday are "an important and powerful tool" in the fight to reduce tobacco-related disease and death, said Food and Drug Administration Commissioner Margaret A. Hamburg. She said the new campaign could induce as many as 213,000 of the nation's 46 million cigarette smokers to quit in the first year. The American Lung Assn. warned local quit lines to brace for a deluge of calls.
Hamburg and other officials also emphasized that the FDA would continue to study the effects the images have on the public, and would probably update them yearly in an effort to keep them and their message fresh in consumers' minds. Outside experts said the government would have to vary the messages to avoid what psychologists call "wear out."
The nine images chosen by the FDA — the first update to cigarette-package warnings in a quarter-century — are stark and often disturbing. Each is accompanied by simple text informing cigarette buyers of the known consequences of their habit. One of the nine appears to depict a cadaver after an autopsy and states simply, "Smoking can kill you."
Another, set against the warning "Cigarettes are addictive," shows a man blowing cigarette smoke out of a tracheostomy hole in his neck.
Other warnings make a clear appeal to smokers' concerns about the effects on others, an approach that research has found highly effective in getting them to try quitting. In one, a photo of a distraught woman bears the warning, "Tobacco smoke causes fatal lung disease in nonsmokers." In another, a toddler clutched to the chest of an adult gazes anxiously at a nearby swirl of smoke, accompanied by the message, "Tobacco smoke can harm your children."
Only one of the images conveys hope and encouragement to the dwindling number of Americans who cling to their smoking habit despite growing social isolation and, in almost four of five smokers, a strong desire to quit. In it, a robust, 30-something man with a sharp-looking goatee and a determined stare pulls open his shirt to reveal a T-shirt that declares, "I Quit." The text reads, "Quitting smoking now greatly reduces serious risks to your health."
The initiative is the most dramatic such effort by the FDA since the 2009 Family Smoking Prevention and Tobacco Control Act gave the agency expanded regulatory powers over tobacco. It is also the first time in 25 years that the health warnings on the packaging of tobacco products has been updated beyond the bland statement, in small type, that the surgeon general of the United States has determined cigarette smoking to be harmful to human health.
The new warnings didn't impress everyone Tuesday.
"They're obnoxious," said Long Beach resident Bob Kohl, a 60-year-old smoker of 43 years who was diagnosed two years ago with emphysema and has quit three times. "They are insulting. They are very specifically condescending, which irritates me. It's nothing I haven't seen before, and it's going to be meaningless to the kids because their attitude is worse than mine."
In requiring the graphic warnings, the U.S. joins about 40 other countries that require cigarette packaging to carry prominent — and often grim — warnings on the dangers of smoking. Canada and European countries pioneered the practice, and several developing countries, including Mauritius, Uruguay, Thailand, Malaysia and India, also requiregraphic anti-smoking messages.
Starting Sept. 22, 2012, the images and related text will cover the top half of all cigarette packages sold in the U.S., making them "new mini-billboards for prevention," said Dr. Howard Koh, assistant secretary for health at the Department of Health and Human Services.
The warnings, added William Corr, deputy secretary of the department, "will forever change the look" of the 15 billion packs of cigarettes purchased by Americans annually. The mandated package coverings "tell the truth," Corr said, contrasting them with messages crafted by the tobacco industry, which spends $12.5 billion annually to advertise its wares.
The images were culled from 36 candidates the FDA circulated for public comment starting last June. The agency ruled out some far more disturbing images, including an unsparing photograph of a bald lung cancer victim hollowed out by her disease.