Tobacco labels crank up the horror factor and, maybe, their impact

Cigarette labels are going for the throat. If you’ve ever peeked at the gross-out pictures in a medical book, you’re really going to want to check out the new warning labels that will soon appear on all cigarette packages sold in the U.S.

The tobacco labels — unveiled Tuesday by the Food and Drug Administration — definitely ratchet up the shock value. Instead of a few stern words from the surgeon general, new packages will feature graphic pictures — a guy blowing smoke through a tracheotomy hole in his neck, a corpse with an evidently unsuccessful surgical scar running down his chest, a cancerous lip, a set of diseased lungs. One of the labels features a cartoon of a distressed baby in an incubator along with the warning that “smoking during pregnancy can harm your baby.”

It’s hard to imagine that anyone in the market for a pack of smokes doesn’t know that smoking can be unhealthy. In many ways, showing a smoker a diseased lung is like posting pictures of overweight people along a buffet line. If you don’t know that cigarettes are dangerous, you may also be surprised to learn that coffee is hot and knives are pointy.

Smokers won’t learn anything new, but there’s a good chance that some of them will be inspired to give up the habit, or at least smoke less.

Canada provides a good example. Our neighbors adopted new graphic labels in 2000, including one that features a picture of a limp cigarette accompanying a warning that smoking can cause impotence. A telephone survey conducted the following year found that about one in five smokers claimed to smoke less because of the labels. Interestingly, the smokers who had the strongest emotional response to the pictures were the ones most likely to cut back.

The researchers concluded that it’s hard to go too far when putting warnings on cigarettes. The more shocking and disturbing, the better.

“We know from other countries that graphic, hard-hitting warnings are more likely to be effective,” says study co-author David Hammond, an associate professor in the department of health studies and gerontology at the University of Waterloo in Ontario, Canada.

Hammond, who has consulted on warning labels around the world, says the new batch of labels in the U.S. includes some hits and misses. Notably, he thinks the warning about smoking during pregnancy would carry more punch with a picture of a real baby instead of a cartoon.

The new U.S. labels are mild compared with some. Cigarette packs in Brazil look like stills from a horror show: a gangrenous foot with missing toes, a dead fetus in an ashtray surrounded by cigarette butts... you get the idea. Probably not entirely coincidentally, smoking rates in Brazil have reportedly dropped from about 35% in the late 1980s to 17% by 2007.

The new warnings in the U.S. may seem heavy-handed, but that’s exactly what’s needed to drive home the message, says Maansi Bansal-Travers, a research scientist with the Roswell Park Cancer Institute in Buffalo, N.Y., who advised the FDA about the new warnings.

“A pack-a-day smoker is potentially exposed to the warning message over 7,000 times a year,” she says.

So how many times can a person stand to look at a tracheotomy hole before lighting up? We’re about to find out.