It turns out that other countries are far ahead of the U.S. in this regard and many of their cigarette labels are even more disturbing and graphic. An excellent round-up piece by medical writer Rob Stein in The Washington Post, posted on its website Wednesday afternoon and on the paper’s front page on Thursday, noted that “at least 30 others countries already require graphic warnings, including some, like Brazil, that often go even further than the proposed U.S. messages.” Stein’s piece said that “Canada, which became the first country to require more graphic warnings in 2000, has seen a significant drop in smoking,” and that most research indicates that more graphic images can help discourage cigarette use.
“All the evidence does point to the fact that these things do help,” said David Hammond, a Canadian researcher who worked with the ad agency that helped develop the FDA. Stein quoted his estimates that about one-third of smokers say the graphic warnings reinforced their motivation to quit, and a similar number of former smokers said they were reminded of why they quit. Experts say that the warnings need to be rotated and stay fresh because they get stale.
However, Stein noted that some studies suggest that, “some strong warnings may, paradoxically, encourage smoking.” That position was echoed by historian Edward Tenner, an online correspondent for The Atlantic. “There’s evidence it may backfire,” he said, citing research linking smoking to self-esteem. “Actually Death Cigarettes were a popular novelty brand in England in the 1990s. Wouldn’t it be better to have, say, quit-smoking toll-free numbers in ultra-bold print, and other links to anti-smoking resources? We need not blows to the solar plexus, but the same sophistication and ingenuity that promoted the cigarette habit to begin with,” he wrote.
Other reactions voiced in comments on various sites ranged from the “It’s not enough” camp to the “don’t tread on me health police” variety: “How lovely. I have to see the stained consciences of the morality police externalized in technicolor when I indulge in an occasional cigarette, for pleasure and by my own free choice,” wrote Jacob of New York on The New York Times’s site. The paper splashed its story across the front page too, accompanied by the headline “U.S. Wants Smoking’s Costs to Stare You in Face.”
Finally, turning to some unscientific, man-on-the-street evidence, this correspondent encountered two Italians smoking outside a Stamford, Connecticut restaurant. Turns out they had not yet seen the American media splash over the new warnings but had seen similar warnings on cigarette packages in Europe. They dismissed them as unlikely to be effective, saying they were well aware of the hazards they faced but weren’t willing to give up the habit. Siena Restaurant owner Pasquale Conte, age 45, and a pack-a-day smoker who started in Italy at age 15, thought a far more effective approach was economic. “Raise the cigarette taxes and make them $25 a pack and you’ll have more impact,” he suggested, saying that he was not deterred by the $8.50 he now pays for a pack of Marlboros.