New Graphic Labels Sap Glamour Out of Smoking

New Graphic Labels Sap Glamour Out of Smoking

Next fall, per FDA mandate, cigarette packages will sport hard-to-ignore graphic warning labels depicting corpses, a man exhaling through his tracheotomy, babies sitting in clouds of smoke. The labels don’t just deliver a perfunctory health message – they produce a visceral, emotional response that smokers must reckon with every time they light up.

Even so, big questions remain: Will these vivid images be enough to drive long-time smokers to quit? Can they really deter future smokers from their first cigarette?

To learn more, we tapped Dr. Scott McIntosh, director of the Greater Rochester Area Tobacco Cessation Center and associate director of the Smoking Research Program at URMC’s James P. Wilmot Cancer Center. For his insights, just read on.

Scripts: These new labels don’t just carry a straight-forward safety warning – they produce a powerful emotional response. Do you think this strategy will be effective?

McIntosh: I do. We all know that knowledge alone doesn’t change behavior – that’s why triggering an emotional response along with these fact-based (and let’s be honest, disturbing) images is absolutely critical. Research has shown that this approach actually helps people link a broad message (e.g., smoking is dangerous) with the specific diseases that it causes (asthma, lung cancer, cardiovascular disease, erectile dysfunction, etc.). The FDA predicts the new ads will prompt an anticipated 213,000 Americans to quit within the first year; they’ve based that figure on hard evidence from the experiences of other countries that have already adopted similar labels.

Scripts: Do you think this campaign will be more effective for some demographics than others? Specifically, do you think it might be more powerful in staving off young, future smokers, as compared to getting longtime addicts to quit?

McIntosh: There will be an impact on both fronts: Prompting addicted smokers to quit, and preventing or delaying youth from lighting up. See, the tobacco industry knows that the earlier a person tries cigarettes, the more likely he or she is to become a lifelong smoker; so, if you can delay that first puff, many youth will never become addicted.

As the tobacco industry indicated in some of their internal documents, which became public in the 90’s, they are constantly seeking “replacement smokers.” The cold, hard reality is that smokers eventually either quit or die faster than the industry would like. It’s not a business that is naturally self-sustaining; it must actively recruit.

Scripts: Might people will grow immune to these nine messages?

McIntosh: It’s certainly plausible. That’s why future strategies will introduce new messages, or perhaps even increase the percentage of space that the image is required to occupy on the package (soon to be 50 percent). Historically in America, the norm has been to have bland, small, black-and-white messages, with very few options for rotation (e.g., “The Surgeon General has determined that smoking is harmful to your health”). Smokers quickly ignore such messages. But these eye-catching, memorable, rotating graphic ads will be much harder to shrug off.

Scripts: This campaign really sucks the glamour out of smoking.

McIntosh: That’s the point. It’s a much-needed counter-balance to the suave and sophistication that Hollywood, TV, and the tobacco industry have associated with smoking for too many decades. If it can become the norm to be a non-smoker, if we can smoking loses its status as being “socially acceptable” or even “glamorous,” fewer youth will seek it out, and more current smokers will be motivated to quit.

Scripts: We all know smoking is awful for our health, but can you quickly summarize the dirty realities?

McIntosh: Quitting is the most important public health action any American can take. That’s because so many of the most common, life-threatening diseases – including heart disease, stroke and many forms of cancer – stem from tobacco use. And the most common form of tobacco, cigarettes, results in an estimated 480,000 deaths each year in the U.S. (including 25,000 deaths in New York State alone).

Even environmental tobacco smoke (ETS) unleashes a cocktail of 43 cancer-causing chemicals, accounting for about 62,000 deaths nationwide each year among non-smokers.Approximately U.S. 300,000 children develop lower respiratory tract infections each year from ETS, hospitalizing approximately 15,000 of these kids. These numbers are staggering, especially considering that tobacco addiction is preventable and treatable.

Scripts: But is quitting worth it? Can lifelong smokers “take back” some of their health if they quit now?

McIntosh: Yes, yes, yes. It’s never too late. Quitting smoking at any age is beneficial both in the short and long term. Within mere days of not smoking, carbon monoxide levels return to normal, and nicotine (a poison) is virtually eliminated from the body. Within several months, the cilia – small but important hair-like structures lining the airways – grow back. After a decade, the risk for lung cancer drops by half. After 15 years, the risk for cardiovascular disease is practically identical to that of persons who have never smoked. If that’s not motivating, consider more imminent benefits: if you quit, your medications will likely work better, you’ll be able to catch your breath, your clothes won’t reek.

Scripts: The labels all will include a quitline phone number (1-800-QUIT-NOW). Is this service very effective?

McIntosh: One of our own researchers, Dr. Deborah Ossip, actually conducted key research on the efficacy of telephone quitlines right here in URMC’s Smoking Research Program. We’ve learned that quitlines that are “reactive” (i.e., smokers call the number to speak with a quit coach) are quite successful; the Centers for Disease Control and Prevention actually considers them to be an intensive, front-line treatment for nicotine addiction. On top of this,proactive calls from the quit coach to a smoker can further increase the effectiveness of telephone counseling. The New York Smokers’ Quitline even offers two such proactive calls for New York smokers referred by their healthcare provider; it’s one of the most heavily used quitlines in the world, and has been an integral part of the state’s comprehensive tobacco control program – which has helped shrink the prevalence of smoking in New York.

In addition, web-assisted tobacco interventions have proven to be helpful, too. The New York State Smokers’ Quitsite (www.nysmokefree.com) has an interactive program called “Click to Quit.” You can order two free weeks of nicotine replacement therapy (patch or gum) right online – or by calling the quitline directly at 866-NY-QUITS.

For more tips on quitting, click here, or visit the New York State Smokers’ Quitline (1-866-NY-QUITS/1-866-697-8487) or www.nysmokefree.com (New York Smokers’ Quitsite).

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*  The above story is adapted from materials provided by University of Rochester Medical Center

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