- US has not implemented the use of front and back of-the-pack pictorial warnings, recommended by the World Health Organization.
- An industry lawsuit stalled the implementation of this requirement and currently a text-only warning appears on the side of the cigarette packs.
- A recent study looked at changes in smoking rates in Australia, Canada and the United Kingdom, which have already implement prominent pictorial warning labels (PWL).
- The study predicted that implementing PWL would reduce smoking prevalence in relative terms by 5% in the near term, increasing to 10% over the long-term.
Using prominent, graphic pictures on cigarette packs warning against smoking could avert more than 652,000 in the U.S. over the next 50 years.
Researchers from Georgetown Lombardi Comprehensive Cancer Center say that it can also reduce up to 92,000 low birth weight infants, up to 145,000 preterm births, and about 1,000 cases of sudden infant deaths.
The study, published online in the journal Tobacco Control, is the first to estimate the effects of pictorial warnings on cigarette packs on the health of both adults and infants in the U.S.
Pictorial warnings have been required by law, but an industry lawsuit stalled implementation of this requirement.
Currently, a text-only warning appears on the side of cigarette packs in the U.S.
The study used a tobacco control policy model, SimSmoke, developed by Georgetown Lombardi's David T. Levy, PhD, which looks at the effects of past smoking policies as well as future policies.
SimSmoke is peer-reviewed, and has been used and validated in more than 20 countries.
In this study, Levy and his colleagues, who included investigators at the University of Waterloo, Ontario, and the University of South Carolina, looked at changes in smoking rates in Australia, Canada and the United Kingdom, which have already implement prominent pictorial warning labels (PWLs).
The study found that eight years after PWLs were implemented in Canada, there was an estimated 12% - 20% relative reduction in smoking prevalence.
After PWLs began to be used in Australia in 2006, adult smoking prevalence fell from 21.3% in 2007 to 19% in 2008.
After implementation in the UK in 2008, smoking prevalence fell 10% in the 2009.
The researchers used these and other studies and, employing the SimSmoke model, estimated that implementing PWLs in the U.S. would directly reduce smoking prevalence in relative terms by 5% in the near term, increasing to 10% over the long-term.
If implemented in 2016, PWLs are estimated to reduce the number of smoking attributable deaths (heart disease, lung cancer and COPD) by an estimated 652,800 by 2065 and to prevent more than 46,600 cases of low-birth weights, 73,600 cases of preterm birth, and 1,000 SIDS deaths.
"The bottom line is that requiring large pictorial warnings would help protect the public health of people in the United States," says Levy, a professor of oncology.
"There is a direct association between these warnings and increased smoking cessation and reduced smoking initiation and prevalence. That would lead to significant reduction of death and morbidity, as well as medical cost."the professor added.
The study was funded by a grant from the National Institute on Drug Abuse and the National Cancer Institute.