The U.S. Needs Ugly Smoking Pictures, Too

Cigarettes in Australia.

Photographer: Cameron Spencer/Getty Images

Graphic images of diseased lungs, rotting teeth and people smoking through tracheotomy holes aren’t the best way to sell cigarettes. Which is exactly why they feature so prominently on cigarette packs in dozens of countries -- and should in the U.S. as well.

More than seven years ago, Congress mandated such labels, covering at least half of the fronts and backs of packs. But the Food and Drug Administration has been dragging its feet on carrying out the law, and its delay deprives the U.S. of a proven weapon against a deadly public health enemy. Some 17 percent of Americans still smoke, and almost half a million die each year as a result.

Pictorial labels could save more than 652,000 lives in the U.S. over the next 50 years, and prevent 47,000 preterm births, a new study suggests. And this is only the latest research to demonstrate the labels’ power. Experience has shown that explicit and direct anti-tobacco messages cause smokers to quit, or at least think about quitting.

Images tend to work best when paired with written warnings, such as “Cigarettes are addictive,” “Cigarettes cause strokes and heart disease” and “Cigarettes can kill you.” The 2009 Tobacco Control Act requires that one of these or six other statements also be found all cigarette packs sold in the U.S. These statements are more blunt than the familiar surgeon general’s warnings now tucked away on the sides of packs (“Quitting Smoking Now Greatly Reduces Serious Risks to Your Health”). But none have yet been used.

At first, the FDA seemed eager to carry out the Tobacco Control Act. In 2011, the agency met its deadline to issue a rule requiring specific pictures on cigarette packs. As expected, tobacco industry sued, and a federal court said that the rule was an unconstitutional restriction of free (in this case commercial) speech.

The court left room for the FDA to appeal with a better justification for the rule, however. It has failed to do so for four years now, and last month, eight public health groups (including the Campaign for Tobacco-Free Kids, which is supported by Michael R. Bloomberg) sued the FDA to push it forward.

As the groups point out in their complaint, the delay has been time enough for more than 3 million Americans to start smoking -- half of whom will probably die as a result. The new evidence of graphic labels’ life-saving potential should make it easier for the FDA to justify a revised set of labels, and spur the agency to move faster.

To contact the senior editor responsible for Bloomberg View’s editorials: David Shipley at davidshipley@bloomberg.net.