Cigarette Warnings: Is Bigger Better?

Study: Larger Labels With Pictures — As in Other Countries — May Make Smokers Think Twice

(WebMD)  American cigarette warning labels might be more effective if they were big and graphic — like those in some other countries, according to a new study.

The news appears in the March issue of the American Journal of Preventive Medicine.

In the study, researchers surveyed nearly 15,000 adult smokers in the United States, U.K., Canada, and Australia to test the effectiveness of the warning labels used in those four countries. The surveys were conducted between 2002 and 2005. The key finding: The U.S. labels, which were the smallest and least detailed, were also the least effective.

"The current findings, along with previous research, suggest that U.S. smokers might benefit from large graphic warnings on cigarette packages," write the researchers, who include David Hammond, Ph.D., of Canada's University of Waterloo.

U.S. cigarette labels include four warnings written on the side of cigarette packages.
Canadian, Australian, and British cigarette warning labels are much bigger, include more health warnings, and appear on the front and back of the packages.

The Canadian label covers half of the front and back of cigarette packages. It includes 16 warnings in print as well as pictures, such as a graphic suggestive of impotence and the words "Tobacco use can make you impotent."

The Australian label includes six written warnings but no pictures. It covers a quarter of the front and a third of the back of cigarette packages.

The U.K. revised its cigarette warning label in late 2002, adding 10 written warnings (such as "Smoking when pregnant harms your baby") for a total of 16 written warnings on the front and back of the package. The warning text was also enlarged at that time.

Some other countries get even more graphic with their warning labels, according to the report. For instance, a Thai label includes a picture of a man smoking, with skulls floating in the background. A Brazilian label shows an unhappy couple in bed, with a warning about impotence from smoking.

Another label image proposed (but not required) by the European Union is a drawing of a dead man, his eyes covered by a cloth, lying on a table. The words "Smokers die younger" appear next to that image. Hammond's team didn't analyze the effectiveness of those labels.

In the surveys, Hammond's team asked smokers in the four countries studied how often they noticed the warning labels on cigarettes and whether the labels made them try to quit smoking or think about smoking's health risks.

U.S. smokers — who had the smallest, least-detailed warning labels — were the least likely to report noticing or reacting to the labels. "The U.S. warnings performed poorly compared to those in other countries," write Hammond and colleagues.

In contrast, Canadian smokers — who had the biggest, most graphic warning labels of the four countries — reported the greatest impact from those labels. Australia ranked second, followed by the U.K.

But the British label change made an impact on smokers, boosting their awareness and quit-smoking attempts — at least at first. That effect faded within 21/2 years after the label change, probably because British smokers had gotten used to the new label, Hammond's team notes.

U.S. warning labels may need a makeover to become more effective, the study suggests.
"The health warnings that appear on the side of U.S. cigarette packages provide even less health information than many other, more benign consumer goods," write Hammond and colleagues.

They point out that quit-smoking tips and encouragement are packed inside Canadian cigarette packages.

Putting quit-smoking resources (such as web sites and toll-free smoking cessation phone lines) on cigarette packages might also help, Hammond's team suggests.

SOURCES: Hammond, D. American Journal of Preventive Medicine, March 2007; Vol. 32: pp. 210-217. News release, Elsevier Health Sciences.

[ozziepooh90]

get over it already, everyone even smokers knows the effects but don't really care. Most of the people that smoke are adults and can think for themselves !!!!!! Isn't eating fry foods bad for the health, chocolate, etc., why don't we raise taxes on them too and make bigger labels. And yes i know it doesn't effect other people as the way smoke does. I would really like to see the proof they have that second hand smoke really causes cancer, my gosh the only reason they can say that is because at some point in time everyone has been around some smoke. I would rather be closed in a room full a smokers than a car running !!!!!!

[susanhelit]

If you would like to see proof second hand smoke causes cancer - just go look at it... sigh

There's a ton of studies, just take your choice. Or continue to choose ignorance. If you're the type who can't believe studies, and responds to emotional anecdotal evidence, go talk to some bartenders, waitresses - it's not hard to find a bunch of them with lung problems if they had to work in a smoke filled environment, and some with the cancer. I know one myself.

For an interesting bit of proof though - take a look back in history. Until cigarette smoking became popular, lung cancer was a very rare disease - as in incredibly rare, a doctor might see it once in their career if at all.

[uceslady]

Wonder what the comparison is of tax collected on cigarette sales to those of liquor sales? Do you think our Uncle Sam cares anything about John Q. Public? There is another agenda here. Cigarettes do not effect the mind and all the other perils liquor does. When are they going to ban liquor again? Guess now they will say all the cigarette smoke as caused the green house effect too! Don't think our forefathers intended for the lawmakers to have this much control over the citizens of the United States. Wonder if insurance companies are involved in this? You can bet somebody is!

[susanhelit]

Yep, if you want to smoke, it's up to you.

Of course, when you get sick, and spend a couple years dying, it's often our tax dollars that pay for your care - so I think it's pretty reasonable for the government to take steps to educate you, in the hopes you choose differently, with the facts staring you in the face.

And, of course, to say that you can't force others to breathe your secondhand smoke - your freedom to ends where my lungs begin.

[dixiebobh]

The government (BIG BRO) is manipulating your and my lives. Smoking a bad for your health. Everyone knows that. Drinking is bad for you and the poor slob you run over and main or kill. Gambling is bad for your children who have to walk barefooted in the snow 'cause you can't afford shoes for them. Riding motorcycles is dangerous, so wear a helmet, or ELSE SAYS BB. Kids should wear ridiculous looking helmets when riding a bike. We must wear seat belts in a car. Isn't it wonderful that the government cares for us like it does? Makes me feel all fuzzy.

But why are our young men and women, the future of our country being sent to Iraq as cannon fodder?

Go ahead, smoke and enjoy!

[tuckerndfw]

Susan,

Does your jingoism also apply to exhaust fumes, perfumes and all other noxious emissions?

Or, do you pick and choose which "freedoms" you support?

My father smoked and drank his entire life and keeled over dead of a heart attack at the age of 73.

My mother and her father neither smoked nor drank and both ended up in nursing homes where they "lived" (existed in body) for several years before finally withering away, suffering from Alzheimer's.

Jingoism may sound good to morons who actually believe that ***, but statistically, smokers do not cost more to maintain in their old age.

Smokers have the right to smoke anywhere people are allowed to wear perfume, drink alcoholic beverages, ingest sugar, caffeine, or any other substance with known health risks, or anywhere people are allowed to engage in any behavior that may constitute any level of risk to themselves or others.

No one has the legitimate authority to pick and choose risk levels for other people engaged in legal activities.

So far, smoking is still a legal activity.

[tuckerndfw]

RE: "second hand smoke"

There is no possible way "second hand smoke" can be isolated as a determinative cause for anything. Especially given the fact no one knows what causes cancer.

The causes of cancer are far too numerous to assign a cause to a single substance. Claiming tobacco (or cigarette paper) causes cancer is similar to asserting four door sedans cause global warming. They may be a factor, but they are not the cause.

Anti-tobacco zealots have yet to explain how it is people can use tobacco their entire lives and never have cancer or any other symptoms or diseases they claim tobacco causes.

"Second hand smoke" is one of the most unscientific and ridiculous assertions ever foisted on people by "scientists" who promote their personal agenda rather than science.

[dixiebobh]

SUSAN H., YOU MUST BE A LOT YOUNGER THAN I. I REMEMBER VIVIDLY FULL PAGE ADVERTISEMENTS IN NATIONAL MAGAZINES SUCH AS "LIFE" WITH A PICTURE OF A PHYSICAN SMOKING A CIGARETTE. THE BYLINE WAS, "MORE DOCTORS SMOKE CAMELS THAN ANY OTHER CIGARETTE".

SMOKING AS BEEN A NATIONAL PASSTIME SINCE COLONIAL DAYS. PRIOR TO THE 1960'S, MEDICAL SCIENCE AND TOBACCO EXISTED TOGETHER HAMONIOUSLY. B.S.G. (BEFORE SURGEON GENERAL).

REMEMBER GOOD OLD SIR WALTER RALEIGH? GOD LOVE HIM, THERE IS A WONDERFUL PIPE TOBACCO NAMED AFTER HIM! HOW ABOUT THOSE INDIANS? I WONDER WHAT THEY WERE SMOKING IN THOSE BIG PIPES?

SO MY DEAR LADY, EXERCISE YOU FREEDOM TO SHUN US VILE CREATURES, BUT IN THE NAME OF ALL THAT IS HOLY, LEAVE US ALONE----PICK ANOTHER SEGMENT OF HUMANITY TO PICK ON. MAYBE THE SOCIAL DRINKERS WITH MARTINI IN HAND WITH THE PINKIE EVELATED JUST RIGHT?

[three-o-six]

No tucker -- the most ridiculous assertions by scientists is "Global Warming"

[susanhelit]

Perfume and other noxious emissions are obnoxious, and can trigger migrane headaches for me.... but they are not going to cause cancer, so, no, I've got no problem with them. Cigarettes cause cancer and a ton of other diseases, both in smokers (who can make their own choices, but I can hardly see why they object to labels on the cigarettes educating them about the impact of the choice they are makeing), AND in non-smokers exposed to their smoke.

You can choose to smoke for yourself. You cannot choose to smoke for me. Pretty simple, right?

[susanhelit]

I am younger - but even in the days you talk of, they knew cigarette smoking caused cancer, and were on the trail of secondhand smoke. But doctors and scientists were being paid and hired to lie - simple as that. Over time, it got figured out.

What I don't see, is if you all are so happy with your choice to smoke (or if you are so very determined that it remain a freedom for others) - why do you have an objection to a warning on the package telling you about the health risks? It's done for other products, why not this one?

And the scientific evidence on secondhand smoke is solid, so, no, you can't force me to breathe it - you want to have all the choice to smoke, but take that choice away from me? Nope. You made your choice, I made mine.

[tuckerndfw]

Susan,

There is NO possible way you can support your assertion that perfumes or other noxious odors do not cause cancer.

"Scientists" set out to "prove" second hand smoke "caused" cancer and that is what they concluded. That is not science, that is propaganda and the same method can be used to "prove" drinking water or anything else causes cancer.

I do not smoke but that does not mean I belong to the anti-tobacco zealots.

Anti-tobacco zealots are little different than any other group of zealots and encouraging them is poor public policy.

[tuckerndfw]

Susan,

Cigarette smoke does NOT cause cancer.

Listen up, CIGARETTE SMOKE DOES NOT CAUSE CANCER.

No one KNOWS what CAUSES cancer.

If we KNEW what CAUSED canced, we would develop a cure. But since we don't, we can't.

Pardon me for raising my voice, but you continue to repeat anti-tobacco zealot propaganda as if it was factual.

What you claim is not supported by the facts. The majority of smokers do not develop cancer, conclusively proving smoking does NOT "cause" cancer.

Cancer is more hereditary than it is environmental. And, the bottom line is no one knows what causes cancer, not even those "scientists" who (falsely) claim "second hand smoke" causes cancer.

[michellem99-2009]

I have seen the TV ads that was aired in the 60s before they were banned on the air waves. The ones that stuck out were the father like son ads, they were painting the out side the house,yark work. tinkerering on the family car. The son did the sane thing as his dad down to the cigerette. Why we had candy cigerettes. Haven't seen them in years. I don't smoke and never have. I have always hated 2rd hand smoke. So any means to get accross the damages of smoking on the human body and also the damages of 2rd hand smoke all the better. It truly does cause health issues. I have a parent who has to use oxygen 24/7 and friend who has diabetes,heart problems ,lung problems due to years of smoking. I know that for years there was no warning on the smokes..Make them in extra large print, what ever it takes to get massages on the packs. It is so needed. Thank you.

[susanhelit]

Even tobacco companies admit that smoking causes cancer. I'm sorry you bought into their earlier propaganda attempts, but there is no huge anti-tobacco lobby, just the scientists who told the truth, doctors who noticed that their smoking clients tended to die from certain diseases, and so forth. And after awhile of the tobacco companies fighting this with false studies and lies, even they finally admitted to it.

Same for secondhand smoke. I don't know that perfume and the like don't cause cancer, but so far, there's no link. You can find studies about non-smoking waitresses in smoking bars and how much more often they get cancer than anyone else, but the same isn't true for workers in the Macy's perfume aisles. If it turns out it does cause health problems, then it'll go the way of cigarettes.

[susanhelit]

Oh, by the way - we know what causes the common cold. Does that mean we have a cure for the common cold? Nope, not even close! So tucker, I'm afraid that knowing how a cancer is caused doesn't help us a bit in curing it. Except in one way - we know enough to tell you to keep smoke, especially cigarette smoke (amazing the chemicals in that stuff) out of your lungs, to prevent lung cancer.

[akarsno]

To me ... it is so simple, they know smoking is bad for humans, than if it is destroying us why does the goverment allow those company's to continue to make them.

If they we shut down once and for all and not legal anymore ... would we not be saving human lifes as we are trying to do everyday.

Not only that ... would it not be good for the enviroment too and the people around us.

Let's start with shutting down those company's once and for all and at the same time ... help those smokers to quit for their own health sake.

Of course there are other ways to save the human race but this is a start!

[uceslady]

Follow the money trail.....You might be surprised where it ends!