U.S. health officials are making a new attempt at adding graphic images to cigarette packets to discourage Americans from lighting up.
The Food and Drug Administration on Thursday proposed 13 new warnings that would appear on all cigarettes, including images of cancerous tumors, diseased lungs and feet with amputated toes.
Other illustrations would warn that smoking can cause heart disease, impotence and diabetes. The labels would take up more than half of the front of cigarette packages and include text warnings, such as “Smoking causes head and neck cancer.” The labels would also be on tobacco advertisements.
The current smaller warnings on the side of U.S. cigarette packs have not been updated since 1984. They warn that smoking can cause lung cancer, heart disease and other illnesses. These warnings “go unnoticed” and are effectively “invisible,” the FDA said it its announcement.
The FDA’s previous effort was defeated in court in 2012 on free speech grounds. A panel of judges later upheld the decision, siding with tobacco companies that the agency couldn’t force cigarettes to carry grisly images, including cadavers, diseased lungs and cancerous mouth sores.
The FDA said its revised proposal is supported by new research that documents how the warnings will help educate the public about smoking harms. The agency will take comments on the proposal before moving to finalize the labels.
Nearly 120 countries around the world have adopted the larger, graphic warning labels. Studies from those countries suggest the image-based labels publicize smoking risks and encourage smokers to quit.
Current U.S. cigarette labels don’t reflect the enormous toll of smoking, said Geoff Fong, who heads the International Tobacco Control Project.
“This is a deadly product,” said Fong, who studies anti-tobacco policies at Canada’s University of Waterloo. “We have more prominent warnings on many other products that don’t pose even a fraction of the risk that cigarettes do.”
Canada became the first country to put graphic warnings on cigarettes in 2000.
Smoking causes more than 480,000 deaths each year in the U.S, even though smoking rates have been declining for decades. Approximately 14% of U.S. adults smoke, according to government figures. That’s down from the more than 40% of adults who smoked in the mid-60s.
Under the 2009 law that first gave the FDA oversight of the tobacco industry, Congress ordered the agency to develop graphic warning labels that would cover the top half of cigarette packs. The FDA proposed nine graphic labels, including images of rotting teeth, a blackened lung and a smoker wearing an oxygen mask.
But the three-judge panel ruled that the FDA’s plan violated companies’ right to free speech. The judges said the images were “crafted to evoke a strong emotional response,” rather than to educate or warn consumers.
The FDA said it would develop a new batch of labels that wouldn’t run afoul of the First Amendment. When new labels didn’t appear, eight health groups sued the agency in 2016 for the “unreasonable delay.”
Under a court order this year, the FDA was required to propose new labels by August, with final versions by next March.
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