Its time for pictorial warnings on cigarette packs.

Virtually everyone knows that smoking is bad for health. But smokers typically don’t give much thought to the effects on their own health until they have been smoking for years. They also tend to be less aware of effects other than lung cancer (e.g. cardiovascular effects, effects on reproductive health etc). Health warnings first appeared on the side of US cigarette packs in 1965, stating that, “Cigarette smoking may be hazardous to your health.” The labels on U.S. cigarettes have not changed since 1984 and appear in small black and white print on the side of cigarette packs. Can you remember what they say? (most people can’t).

Messages given in small print on the side of the pack clearly lack salience and persuasive power compared with more colorful, larger messaging placed on the front of the packs. An expert panel commissioned by the National Academy of Sciences described the current warnings as “woefully deficient.” In an effort to help smokers be more clear about the health effects of cigarettes, many other countries around the world (including Australia, Belgium, Brazil and Canada) have introduced larger pictorial health warnings on cigarette packs.

You can view the pictorial health warnings from other countries around the world at: . These warnings provide quite a contrast to those in use in the United States, and may even help increase a smoker’s motivation to quit simply by viewing them online.

Some recent studies indicate that current U.S. warnings are woefully ineffective at getting the attention of smokers, communicating health risks or motivating smokers to quit, whereas the type of pictorial warnings used in Canada are much better. David Hammond and colleagues at University of Waterloo in Canada examined Canadian smokers’ reactions to the pictorial warnings in Canada. Over 90% of smokers had read the new warnings and those who read them, thought about and discussed the new Canadian warnings were more likely to have quit, made a quit attempt, or reduced their smoking three months later. Dr Ellen Peters and colleagues from University of Oregon recently compared US warnings with those in Canada. A majority of both smokers and non-smokers endorsed the use of Canadian-style warnings in the United States.

A bill currently pending in Congress would give the U.S. Food and Drug Administration (FDA) authority to require major changes in U.S. cigarette pack health warnings and require that they cover at least the top 30 percent of the front and back of cigarette packs. The legislation would also allow the FDA to increase the warning size to 50 percent of the front and back panels and adopt graphic or pictorial warnings, as Canada and several other countries have already done. Some countries also include the toll-free number for the national Smokers Quitline next to the warning. Its time to upgrade the health warnings on cigarette packs in the United States to include pictorial warnings and the national quitline number (1-800 QUIT NOW).
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About the Author

MA, MAppSci, PhD

Dr. Jonathan Foulds is an expert in the field of tobacco addiction.