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New Report Shows U.S. Lags Behind Much of the World in Requiring Graphic Cigarette Warnings – the FDA Must Act to Catch Up

Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids
October 14, 2014

WASHINGTON, DC – A new report issued today shows that the United States has fallen far behind much of the world in requiring large, graphic health warnings on cigarette packs. The report should spur the Food and Drug Administration to quickly develop and implement such warnings, as required by U.S. law.

The U.S. is tied for last among 198 countries/jurisdictions based on the size of its warnings, woefully behind the 77 countries/jurisdictions that have finalized picture warning requirements, according to the report, Cigarette Package Health Warnings: International Status Report, issued by the Canadian Cancer Society. The pictorial warnings are spreading rapidly: Canada was the first country to implement such warnings in 2001, and two years ago, when the last edition of the report was issued, 55 countries required picture warnings.

The current U.S. warnings, which are text-only and printed on the side of cigarette packs, are stale and unnoticed. They haven’t been updated in 30 years and are among the least effective in the world. In 2009, a large, bipartisan majority of Congress passed a law mandating graphic warnings that cover the top half of the front and back of cigarette packs and 20 percent of cigarette ads. In June 2011, the FDA issued a comprehensive set of graphic warnings.

Tobacco companies filed two lawsuits challenging the graphic warnings, leading to two federal appellate court rulings. The U.S. Court of Appeals for the D.C. Circuit struck down the specific warnings proposed by the FDA. However, the U.S. Court of Appeals for the Sixth Circuit upheld the law’s underlying requirement for graphic warnings, finding that the warnings 'are reasonably related to the government's interest in preventing consumer deception and are therefore constitutional.' The U.S. Supreme Court declined to hear a tobacco industry appeal of the Sixth Circuit ruling, preserving the FDA's authority to develop new graphic warnings.

The FDA stated in March 2013 that it would begin developing new warnings, but 19 months later it has yet to act. The FDA has taken far too long to develop new warnings, and should move quickly to require strong warnings that are based on the best available science, can withstand legal scrutiny and fully inform Americans about the deadly consequences of smoking.

As the Canadian Cancer Society report affirms, studies around the world show that large, graphic warnings are most effective at informing consumers about the health risks of smoking. These warnings discourage children and other nonsmokers from starting to smoke and also motivate smokers to quit (see our fact sheet summarizing this evidence).

Tobacco companies fight graphic warnings precisely because they know such warnings are effective. They spend billions of dollars to play down the health risks of smoking and glamorize tobacco use. Graphic warnings tell the truth about how deadly and unglamorous cigarette smoking truly is. Graphic warnings are a vital tool in winning the fight against tobacco, which is the number one cause of preventable death in the U.S. and kills 480,000 Americans each year.

The Canadian Cancer Society report finds that Thailand has the world’s largest warnings, mandating that they cover 85 percent of both the front and pack of the pack, followed by Australia, which was the first nation to require that cigarettes be sold in plain packaging, without brand colors and logos. Almost half of the world's population is covered by the 77 countries/jurisdictions that have finalized picture warning requirements. And 60 countries/jurisdictions have required warnings to cover at least 50 percent of the package front and back (on average), up from 47 in 2012, 32 in 2010 and 24 in 2008.