By Dr. Kate Scannell
First Published in Print: 06/25/2011
TOBACCO MANUFACTURERS are fuming over the new warning labels that will be required on cigarette packages beginning next year. Cool camels and virile smokers pictured on current packs will have to make room for images of a stiff corpse. Or a not-so-virile smoker blowing smoke through a tracheostomy hole in his neck. Or a set of decaying teeth framed by cancer-eroded lips. In all, there will be nine possible graphic options associated with deadly serious text warnings about the life-threatening risks of tobacco consumption.
Last week, the Food and Drug Administration (FDA) revealed these new warning labels in advance of mandating their appearance on all cigarette packages and advertisements in the United States. By the fall of 2012, they are expected to occupy at least the upper half of the front and rear panels on cigarette packs, and at least the upper 20 percent of each ad.
Not surprisingly, cigarette manufacturers don't want to cough up so much marketing space for such vivid reminders of the disease and mortality firmly associated with their products. In fact, they are challenging the legality of the FDA's authority to mandate the new warning labels in a federal appeals court next month.
Besides alleging that the FDA is violating their constitutional right to free speech, they also complain that the new labels are a drag -- forcing brand logos to the lower half of cigarette packs where they are harder to see.
But the FDA believes the new labels will serve a higher purpose and public good. They aim to increase awareness of smoking's associated health risks "such as death, addiction, lung disease, cancer, stroke and heart disease" and, hopefully, "empower youth to say no to tobacco" and persuade smokers to quit.
If actual reductions in tobacco consumption follow, many lives will be saved, life expectancy will increase, and medical costs will decline. Already in the U.S., smoking is materially responsible for 443,000 deaths annually, and upward of 25 percent of 12th grade children are smoking.
Still, some critics wonder whether the new warning labels will have any unique power to diminish smoking rates. Citing CDC data published in 2009, they point out that the percentage of U.S. smokers has already declined dramatically -- from about 42 to 21 percent between the mid-60s and 2004 -- without anyone having to stare at labels featuring rotting pairs of sooty lungs or sick newborns in hospital beds.
Additionally, according to Harvard's Center for Global Tobacco Control, our close neighbor Canada has not witnessed higher smoking cessation rates after having used similarly graphic labels since 2000. One label even depicts a limp cigarette surrounded by a forewarning that "tobacco use can make you impotent."
Other critics doubt that Americans -- strongly valuing individual liberties -- will inhale the motivational message the FDA hopes to convey.
Already, some view the FDA's actions as the nattering intrusions of a nanny-state government. They ask, What's next? Labels portraying comatose people plastered on football helmets? Mangled pedestrian bodies popping up on smart-phone screens when someone texts while driving?
They also wonder why tobacco has been singled out for such muscular scolding. Why alcohol is allowed its pretty labels on its bottles and sexy marketing campaigns. Why billion-caloried, fat-drenched, fast-foods don't need repackaging as Sad Meals, adorned with images of obese corpses.
Interestingly, some health specialists worry that the new cigarette labels could inflict emotional violence on smokers that actually deters them from quitting. By causing smokers to feel shame or doom, the labels may have the unintended consequence of disempowering people to change.
Fortuitously, the day I wrote this column, I happened to meet with Jodi Halpern -- a UC Berkeley psychiatrist and philosopher who authored the acclaimed book, "From Detached Concern to Empathy -- Humanizing Medical Practice."
Taking advantage of her expertise in health risk communication, I asked her to comment about the new warning labels. She had not yet seen them -- and we agreed it unwise to study them during our lunch.
Still, Dr. Halpern noted that effective risk communicators -- doctors, nurses, and public health educators -- generally use empathy to maintain patients' hopes and motivation about changing unhealthy behaviors. In contrast, risk communication involving horrific images or terrifying messages that cause someone to experience fear, anxiety, shame, or catastrophic thinking could undermine that hope and motivation.
The aggressive new warning lables have "come a long way, baby" since the initial timid cautions on the sides of packages that whispered "Cigarette Smoking May Be Hazardous to Your Health." Whether they empower people to take heed or just blow smoke remains to be seen. Let's hope the current efforts pitch a lucky strike.
––––––––––––––––––––––––––––––––
Kate Scannell is a Bay Area physician and syndicated columnist. Her most recent book is the novel, "Flood Stage."
Copyright 2011 Kate Scannell
First Published in Print: 06/25/2011
TOBACCO MANUFACTURERS are fuming over the new warning labels that will be required on cigarette packages beginning next year. Cool camels and virile smokers pictured on current packs will have to make room for images of a stiff corpse. Or a not-so-virile smoker blowing smoke through a tracheostomy hole in his neck. Or a set of decaying teeth framed by cancer-eroded lips. In all, there will be nine possible graphic options associated with deadly serious text warnings about the life-threatening risks of tobacco consumption.
Last week, the Food and Drug Administration (FDA) revealed these new warning labels in advance of mandating their appearance on all cigarette packages and advertisements in the United States. By the fall of 2012, they are expected to occupy at least the upper half of the front and rear panels on cigarette packs, and at least the upper 20 percent of each ad.
Not surprisingly, cigarette manufacturers don't want to cough up so much marketing space for such vivid reminders of the disease and mortality firmly associated with their products. In fact, they are challenging the legality of the FDA's authority to mandate the new warning labels in a federal appeals court next month.
Besides alleging that the FDA is violating their constitutional right to free speech, they also complain that the new labels are a drag -- forcing brand logos to the lower half of cigarette packs where they are harder to see.
But the FDA believes the new labels will serve a higher purpose and public good. They aim to increase awareness of smoking's associated health risks "such as death, addiction, lung disease, cancer, stroke and heart disease" and, hopefully, "empower youth to say no to tobacco" and persuade smokers to quit.
If actual reductions in tobacco consumption follow, many lives will be saved, life expectancy will increase, and medical costs will decline. Already in the U.S., smoking is materially responsible for 443,000 deaths annually, and upward of 25 percent of 12th grade children are smoking.
Still, some critics wonder whether the new warning labels will have any unique power to diminish smoking rates. Citing CDC data published in 2009, they point out that the percentage of U.S. smokers has already declined dramatically -- from about 42 to 21 percent between the mid-60s and 2004 -- without anyone having to stare at labels featuring rotting pairs of sooty lungs or sick newborns in hospital beds.
Additionally, according to Harvard's Center for Global Tobacco Control, our close neighbor Canada has not witnessed higher smoking cessation rates after having used similarly graphic labels since 2000. One label even depicts a limp cigarette surrounded by a forewarning that "tobacco use can make you impotent."
Other critics doubt that Americans -- strongly valuing individual liberties -- will inhale the motivational message the FDA hopes to convey.
Already, some view the FDA's actions as the nattering intrusions of a nanny-state government. They ask, What's next? Labels portraying comatose people plastered on football helmets? Mangled pedestrian bodies popping up on smart-phone screens when someone texts while driving?
They also wonder why tobacco has been singled out for such muscular scolding. Why alcohol is allowed its pretty labels on its bottles and sexy marketing campaigns. Why billion-caloried, fat-drenched, fast-foods don't need repackaging as Sad Meals, adorned with images of obese corpses.
Interestingly, some health specialists worry that the new cigarette labels could inflict emotional violence on smokers that actually deters them from quitting. By causing smokers to feel shame or doom, the labels may have the unintended consequence of disempowering people to change.
Fortuitously, the day I wrote this column, I happened to meet with Jodi Halpern -- a UC Berkeley psychiatrist and philosopher who authored the acclaimed book, "From Detached Concern to Empathy -- Humanizing Medical Practice."
Taking advantage of her expertise in health risk communication, I asked her to comment about the new warning labels. She had not yet seen them -- and we agreed it unwise to study them during our lunch.
Still, Dr. Halpern noted that effective risk communicators -- doctors, nurses, and public health educators -- generally use empathy to maintain patients' hopes and motivation about changing unhealthy behaviors. In contrast, risk communication involving horrific images or terrifying messages that cause someone to experience fear, anxiety, shame, or catastrophic thinking could undermine that hope and motivation.
The aggressive new warning lables have "come a long way, baby" since the initial timid cautions on the sides of packages that whispered "Cigarette Smoking May Be Hazardous to Your Health." Whether they empower people to take heed or just blow smoke remains to be seen. Let's hope the current efforts pitch a lucky strike.
––––––––––––––––––––––––––––––––
Kate Scannell is a Bay Area physician and syndicated columnist. Her most recent book is the novel, "Flood Stage."
Copyright 2011 Kate Scannell