New Cigarette Warnings May Have No Measurable Impact

The Department of Health and Human Services has proposed new graphic health warnings as the centerpiece of its new war on smoking, but even HHS seems to concede that such warnings are likely to have no measurable impact, says ASH
By: Action on Smoking and Health (ASH)
Nov. 15, 2010 - PRLog -- New Cigarette Warnings May Have No Measurable Impact
But Many No-Cost Proven Alternatives Were Overlooked

The Department of Health and Human Services has proposed new graphic health warnings as the centerpiece of its new war on smoking, but even HHS seems to concede that such warnings are likely to have no measurable impact, says public interest law professor John Banzhaf, who got health warnings on radio and television which were truly effective - driving down cigarette consumption for several straight years and saving millions of lives, something even the original Surgeon General's report wasn't able to do.

Although similar - in many cases much stronger - graphic health warnings have been required on cigarettes in some 38 different countries, going back more than a decade, there seem to be no studies actually showing a measurable decline in smoking as a result of such warnings, notes Banzhaf, Executive Director of Action on Smoking and Health (ASH), America's first antismoking organization.

A report summarizing numerous studies which have been done regarding graphic cigarette health warnings cites many small surveys showing smokers allegedly more aware of the dangers, more inclined to want to quit, etc., but none seemingly tied warnings to any tangible and measurable results in terms of significant declines in overall smoking rates.

But surveys - where respondents may well provide the answers which seemingly are expected - are no substitute for hard data, especially since cigarette sales are closely tracked for tax purposes and other reasons.  Indeed, other proven strategies have yielded exactly such hard data.

When smoking bans in workplaces and public places were enacted by various states, cigarette consumption declined measurably.  Indeed, the states with the strongest nonsmokers' rights laws generally have the lowest percentages of adult smokers.

Similarly, when states make smoking more expensive by raising cigarette excise taxes, smoking also decreases measurably.  Indeed, Assistant Secretary for Health, Howard K. Koh, M.D., MPH, went out of his way at the press conference to describe in very precise terms exactly what magnitude decline in smoking would be triggered by a given percentage increase in cigarette price.

But, in stark contrast, neither he nor any of the other participants provided any examples of graphic warnings in more than three dozen other countries producing a measurable decline in consumption, and HHS has conspicuously omitted making any predictions about the size of decreases in consumption which might be expected from the new graphic warning requirement it announced.  If there were any such evidence, you would think he would have discussed it, notes Banzhaf.

There are other reasons to doubt that the new health warnings will save many lives or significantly reduce the huge medical and other costs of smoking.  For example, Atlantic magazine cites social psychology evidence from the field of Terror Management Theory that the warnings could even backfire.

A study reported in Miller-McCune magazine, concludes that death-related warnings actually led to more positive attitudes toward cigarette use among many smokers, finding that smokers clung more tightly to their habit as "a strategy to buffer against existential fears provoked by death-related warning messages."

Teens who are increasing inured to - and even turned on by - graphic bloody images of death and injury in movies and video games may not be deterred at all by similar images on cigarette packs.  Indeed, a political cartoon lampooning the effectiveness of the graphic warnings, titled "The Law of Unintended Consequences," shows young children trading them like baseball cards.

Inexplicably, HHS's new strategies for combating the huge smoking epidemic - which costs almost $200 billion a year, most of which is paid by nonsmokers - does not make use of several techniques which have been proven to have a measurable effect on cigarette smoking.  Several require no congressional action, can be put into effect immediately, and, unlike current government antismoking programs which cost billions, would cost taxpayers nothing.  ASH, for example, suggests the following:

1. Adopt the simple ASH proposal presented at the press conference: Just as HHS seeks to protect Blacks and women by requiring all recipients of grants to prohibit discrimination, it could likewise require all recipients as a condition of receiving a grant to protect nonsmokers by prohibiting smoking. Since so many entities - states, cities, universities, corporations, etc. - receive HHS grants, this would not only greatly increase protection for nonsmokers all over the country, but also provide what most now recognize is one of the two most important factors (along with financial disincentives) in persuading people to quit or not to start smoking: smoking bans, which make being a smoker more difficult and inconvenient, and constantly remind them that their smoking is no longer socially acceptable.

2. Publicize two rulings which ASH obtained from the HHS authorizing charging smokers a substantial surcharge on their health insurance premiums to require them to pay more of the huge cost their smoking currently imposes on others. Since creating financial disincentives to smoke - usually in the form of higher cigarette taxes, but also the increased cost to smokers caused by the multi-state tobacco settlement - has been shown to be so effective in persuading smokers to quit, forcing smokers to pay a 50% (the amount specified in the health care reform law) or higher (under current law) surcharge for health insurance would persuade many more people to quit smoking than simply telling them through graphic warnings things they have long known.

3. Actively join efforts by ASH and other organizations to protect children (and not just adults) from secondhand tobacco smoke by banning it not just in bars and workplaces but also in homes and cars. Already judges in more than half of our states have issued orders prohibiting smoking in homes to protect children, more than a dozen states ban smoking in homes with foster children, and a growing number of jurisdictions are banning smoking when a child is in a car. Yet HHS has been conspicuously absent from this effort. This is ironic because several of their proposed warning are hoping to persuade parents to stop smoking around their children simply by telling them something which has been known - and frequently written about - for more than a dozen years: tobacco smoke is harmful to children. Perhaps if they told them that smoking by parents kills thousands of children every year it would have an impact, but the warnings are much weaker.

For more information on ASH's position, please check out: AND

Professor of Public Interest Law at GWU,
FAMRI Dr. William Cahan Distinguished Professor,
FELLOW, World Technology Network, and
Executive Director and Chief Counsel
Action on Smoking and Health (ASH)
America's First Antismoking Organization
2013 H Street, NW
Washington, DC 20006, USA
(202) 659-4310 // (703) 527-8418

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Action on Smoking and Health (ASH), America's first anti-smoking and nonsmokers' rights organization, serves as the legal action arm of the anti-smoking community. It is supported by tax-deductible contributions.
Source:Action on Smoking and Health (ASH)
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