Why the United States is late on graphic warnings about cigarettes

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The United States wants to put graphic images on cigarette packages – the first change in health warnings for tobacco products in 35 years. Other countries have long used such shock tactics to discourage smokers, so why are the US lagging behind?

Graying images of cancerous tumors and lungs and sick feet.

Strong warnings that smoking can cause everything from blindness and bladder cancer to strokes and fetal growth retardation

If the US Food and Drug Administration achieves its goals, these mandatory health warnings will appear on cigarette packages starting in 2021.

These disturbing images – which are presented later in this article – mark the first label change since 1984.

The FDA proposed a similar action nine years ago, but it was finally blocked in court by tobacco companies for reasons of freedom of expression.

Images can be an unwanted addition to American smokers, but in many parts of the world, these images are already part of the price of buying a pack of cigarettes.

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FDA

What does the FDA propose?

If approved, the new FDA warnings will include "photorealistic" color images that describe the health risks of tobacco.

"While most people assume that the public knows all there is to know about the misdeeds of smoking, there are a surprising number of lesser-known risks than smokers and non-smokers, young and old, are simply not aware, "the FDA said. Commissioner Ned Sharples in a statement.

Graphic warnings will cover the top half of the front and back panels of cigarette packs and at least 20% of the top of cigarette ads.

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FDA

"The diseases included in these images will allow the public to better understand the negative consequences of smoking," said Mitchell Zeller, chief of the FDA's tobacco division.

The warnings first appeared on cigarette packs in the United States in 1966 and were last updated in 1984. In the last 35 years, cigarette packs and advertisements have been used for cigarettes. one of four warnings from the Surgeon General, highlighting health issues such as lung cancer, heart disease and emphysema.

"Their unchanged content over the decades, as well as their small size and lack of images, undermine the effectiveness of current warnings," the FDA said in a statement.

According to the FDA, 34.3 million American adults and nearly 1.4 million young Americans aged 12 to 17 currently smoke cigarettes. Despite declining cigarette consumption, smoking remains the leading cause of preventable disease and death in the United States. It kills about 480,000 Americans each year – more than alcohol, HIV, car accidents, illegal drugs, murders and suicides combined.

Erika Sward, deputy vice president of national defense of the American Lung Association, called the graphic warning labels "late."

"The bottom line is that graphic warning labels have been demonstrated, study after study, around the world, to discourage children from starting to smoke and to encourage adults to quit smoking." ", she says. "It's so important."

How do other countries prevent smokers?

According to the World Health Organization, 91 countries already require strong graphic warnings on packaging, covering 52% of the world's population.

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Canadian Cancer Society

This is a huge jump from 20 years ago, when Canada became the first and only country to put graphic warnings on cigarettes. By 2007, this number had increased to nine, or 5% of the world's population, before gradually spreading to the 28 Member States of the European Union and countries like India and New Zealand.

In 2012, Australia became the first country to use a "neutral packaging", which limits the use of logos, colors, branding and promotional information. This is the most severe type of restriction for cigarette packs.

Current regulations required cigarettes to be sold in brown containers with no distinguishing features other than the brand name and the product name. Health warnings illustrating the consequences of smoking aimed to cover 75% of the front of the bag and 90% of the backhand. Even the color – Pantone Cool Gray – and the font – 2C Lucinda Sans Regular – were specifically mandated in the 2012 legislation.

Although the WHO notes that the US has imposed "big warnings" covering at least 50% of cigarette packs, they do not meet WHO standards for best practices.

Why are the United States lagging behind?

This new proposal is not the first time the FDA has attempted to add graphic images to cigarette packaging.

In 2011, in response to Congressional requests, the FDA issued a rule requiring graphics describing the negative consequences of tobacco use on cigarette packaging. But the rule was thwarted when a federal court of appeal found that the agency's plan compromised the protection of freedom of expression.

Jonathan Havens, a former FDA lawyer who worked with the Center for Tobacco Products, which had just been established at the time, said the First Amendment was the main obstacle between the United States and the United States. other countries.

"Not all countries have the First Amendment," he says, which extends protections to businesses and individuals. "It's a pretty simple but agreed point."

Instead of warning consumers of certain health risks, the FDA's first series of graphics was viewed as a mere tactic of "shock and admiration" and not as a reasonable violation of freedom expression of tobacco manufacturers.

"We take freedom of expression more seriously than most of the other things in our country," Havens added.

But experts disagree whether the first amendment should exclude graphic warnings about smoking.

"The Tobacco Control Act gives the FDA the authority needed to protect public health," said Erika Sward, ALA's. "Time and time again, the FDA and the [Obama and Trump] administrations failed. "

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But we still do not know if these new warnings will be challenged in court.

Using a "scientific approach" that focuses on health risks, the FDA "tries to have a better and more defensive case" than last time, "said Mr. Havens. But, "that does not mean that they will win."

Kaelan Hollon, a spokeswoman for Reynolds American, the tobacco maker who led the lawsuit in 2011, said they "were carefully reviewing the latest FDA proposal regarding graphic warnings."

"We strongly support public awareness of the misdeeds of cigarettes," she added, but the way in which these messages are conveyed to the public can not go against the protections of the First Amendment. apply to all speakers, including cigarette manufacturers. "