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Canadian researchers claim that graphic images and warning labels on cigarette packaging do reduce smoking, suggesting the FDA has underestimated their significance.
The saying, "a picture is worth a thousand words" may sound like an advertising executive's mantra, but we often fall for the dream when sleek and glossy images allow us a glimpse of the "perfect world." But does the theory work in reverse?
A report, published in Tobacco Control, shows that when graphic warning labels were printed on cigarette packaging in Canada, smoking rates decreased between 12% and 20%.
The study authors say this challenges the US Food and Drug Administration (FDA) June 2011 findings, claiming the analysis was "flawed."
In August 2012, the US Court of Appeals for the DC Circuit found that the FDA analysis "essentially concedes the agency lacks any evidence that the graphic warnings are likely to reduce smoking rates."
The researchers claim that the FDA significantly underestimated the impact of the warning labels and suggest that their use in the US could potentially lead to a decrease of between 5.3 and 8.6 million smokers.
Canada was the first country in the world to introduce these labels and therefore has more statistical data for measuring their impact than any other country.
In addition, Canada's labeling policy is closer to that of the FDA, meaning it is easier to extrapolate the findings from Canada to the US, especially when coupled with the facts that Canada is culturally and geographically similar.
The researchers claim that smoking rates in Canada fell sharply after graphic warnings were introduced, and they say this was greater than the difference in smoking rates in the US, where there was no change in printed warnings for same time period.
The potential reduction in smoking rates in the US is between 33 and 53 times greater than the FDA's estimate, they say.
Dr. Jidong Huang, lead author of the paper, comments:
"These findings are important for the ongoing initiative to introduce graphic warnings in the US. The original proposal by the FDA was successfully challenged by the tobacco industry, and the court cited the very low estimated impact on smoking rates as a factor in its judgment."
"Our analyses corrected for errors in the FDA's analysis, concluding that the effect of graphic warnings on smoking rates would be much stronger than the FDA found. Our results provide much stronger support for the FDA's revised proposal for graphic warnings, which we hope will be forthcoming in the near future."
Prof. Geoffrey T. Fong, co-author of the paper and the Principal Investigator of the International Tobacco Control Policy Evaluation Project (the ITC Project), which provided the data on cigarette prices for the study, explains that while 60 countries have agreed to adhere to the labeling system, the use of the warnings in many countries has been delayed, sometimes for years.
"Our results provide strong evidence showing the public health benefits of large graphic warnings, and we hope that this will help to support initiatives to implement more effective health warnings throughout the world. Using graphic warnings to inform smokers and non-smokers alike about the harms of tobacco is a sensible and proven method for increasing knowledge, changing attitudes, motivating smokers to quit, and discouraging youth from initiating smoking."
The Centers for Disease Control and Prevention (CDC) states that 19% of American adults are smokers, and that every day almost 4,000 kids younger than 18 years smoke their first cigarette.
The organization also says that in 2011, the cigarette industry spent almost $23 million every day promoting their products.
Written by Belinda Weber
Copyright: Medical News Today
Not to be reproduced without the permission of Medical News Today.
Cigarette graphic warning labels and smoking prevalence in Canada: a critical examination and reformulation of the FDA regulatory impact analysis, Jidong Huang, Frank J. Chaloupka, Geoffrey T. Fong, Tobacco Control, doi:10.1136/tobaccocontrol-2013-051170, Published online 11 November 2013. Abstract.
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Weber, Belinda. "FDA analysis of cigarette warnings 'inadequate'." Medical News Today. MediLexicon, Intl., 26 Nov. 2013. Web.
9 Mar. 2014. <http://www.medicalnewstoday.com/articles/269362>
Weber, B. (2013, November 26). "FDA analysis of cigarette warnings 'inadequate'." Medical News Today. Retrieved from
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