Global Report Shows U.S. Ranks Last… | Campaign for Tobacco-Free Kids
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Global Report Shows U.S. Ranks Last in Size of Cigarette Warnings; FDA Must Act to Catch Up

Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids
November 10, 2016

WASHINGTON, D.C. – The United States is tied for last in the world in the size of warning labels required on cigarette packs, according to a new international report issued today by the Canadian Cancer Society.

The report shows that at least 105 countries and territories now require graphic cigarette warnings (also called pictorial warnings), with 95 of them requiring warnings that cover at least 50 percent (on average) of the front and back of the pack. In contrast, the U.S. has text-only warnings that appear on the sides of cigarette packs and haven’t been updated since 1985. Studies have found that the U.S. warnings have become stale and unnoticed.

This report shows the U.S. has fallen woefully behind the rest of the world in requiring strong and effective cigarette warnings that reduce smoking and save lives. It provides yet another reason why the U.S. Food and Drug Administration (FDA) should move quickly to comply with a 2009 federal law that requires graphic warnings covering the top half of the front and back of cigarette packs and 20 percent of cigarette advertising. Americans deserve this basic public health protection that 58 percent of the world’s population now receives.

Last month, eight public health and medical groups (including the Campaign for Tobacco-Free Kids), and several individual pediatricians, filed suit in federal court in Boston to force the FDA to comply with the law and issue a final rule requiring the graphic warnings on cigarette packs and advertising.

The FDA’s initial attempt to require graphic warnings was blocked in 2012 by a three-judge panel of the U.S. Court of Appeals for the D.C. Circuit, which ruled 2-1 that the specific warnings proposed by the FDA violated the First Amendment. However, ruling in a separate case in 2012, the U.S. Court of Appeals for the Sixth Circuit upheld the law’s underlying requirement for graphic warnings, finding this provision did not violate the First Amendment. The U.S. Supreme Court declined to hear a tobacco industry appeal of this ruling.

Together, these two court decisions mean the FDA is still legally obligated to requiring graphic health warnings, using different images from those struck down by the D.C. Circuit.

Studies around the world have shown that graphic warnings are most effective at informing consumers about the health risks of smoking, preventing children and other nonsmokers from starting to smoke, and motivating smokers to quit. A 2013 study based on Canada’s experience with graphic warnings found that if the U.S. had implemented such warnings in 2012 as planned, the number of adult smokers in the U.S. would have decreased by 5.3-8.6 million in 2013. Another study published this month, modeling the potential impact of graphic warnings in the U.S. based on evidence from other countries, estimated that graphic warnings would reduce the smoking rate by five percent within just a few years and prevent more than 650,000 smoking-related deaths over a 50-year period.

The new report shows graphic cigarette warnings are spreading rapidly around the world. Canada in 2001 became the first country to implement such warnings, and 77 countries required them at the end of 2014. Nepal currently has the world’s largest cigarette warnings with graphic warnings covering 90 percent of the package front and back.

Tobacco use is the No. 1 preventable cause of death, killing about half a million Americans and six million people worldwide each year. It’s time for the U.S. to join the growing number of countries that require graphic cigarette warnings, and other countries around the world should continue to do so as well.