We all know that smoking is a bad thing (for pregnant women and everybody else). But the Family Smoking Prevention and Tobacco Control Act is committed to making sure smokers are reminded of that fact every time they light up. So the FDA is aiming to up the ante on the government’s anti-smoking campaign with new warning labels for cigarette packages. The hardcore campaign has some people in a snit because they find the images unnecessarily scary.
The concept is similar to cigarette packaging implemented in Europe and Canada, featuring specific health warning messages paired with super-realistic photos of people suffering from the negative effects of smoking.
WARNING: Smoking Is Addictive shows a photo of a man blowing smoke out of a tracheotomy.
WARNING: Smoking causes Cancer shows a photo of a wasted-looking patient, hairless from chemotherapy.
WARNING: Tobacco smoke causes fatal lung disease in nonsmokers shows a photo of a young woman convulsed with tears of grief.
And WARNING: Smoking during pregnancy can harm your baby shows….a cartoon.
Of nine proposed labels, the pregnancy warning is the only one that doesn’t use a photo of a human being to make its point. (There is more than one image option offered for each warning label; as an alternative,to the cartoon, the FDA offers a picture of an overflowing ashtray with a pacifier next to it. Which, I’d expect, is an image smoking parents see on a daily basis. Not exactly something that’s going to shock parents into a new awareness.)
I don’t get it. It’s okay for smokers to be subjected to images of autopsies, oxygen masks, smoking holes in the neck, but not a real life baby in the NICU?
A cartoon image is designed to provide distance from reality, to soften the personal connection, making it more universal and less specific. Cartoons have childlike associations, so they’re often used to are used to make difficult things more accessible where they might otherwise be seen as threatening. The problem here is that threatening is the whole point. If these images are supposed to scare people away from smoking, they need to be scary. The baby in that cartoon image doesn’t even look particularly compromised. Yeah, he’s in a NICU bassinet; but the image is cropped so that you can hardly tell. I didn’t even notice the tubes in the first few views as they’re below, rather than above the baby’s face, and the similar shape and line weight makes them blend into the outline of the bassinet. If you’re not studying the picture, you might just think it’s a crying newborn in a hospital nursery.
In Australia, and Canada, pregnancy smoking warning labels show real life newborns, intubated and underweight. Brazil and Mexico go way further, with warnings like “Your Smoking Kills Babies” alongside images showing…dead babies. (I’m not a sadist; you’ll have to look those up for yourself.) In fact, I’d say overall the FDA’s proposed images are incredibly tame compared to the kind of labeling that’s been seen in other countries for nearly a decade. Not all that surprising, considering the historic power of the Tobacco lobby. This country is pretty attached to the association between smoking and freedom. I can understand why many smokers are against this, too. If these labels are implemented, it will be a big bummer for smokers. I smoked some before I had kids, and I know the complexities of smoker/cigarette relations. A certain suspension of disbelief is required every time you put one in your mouth. Forcing smokers to be conscious of the risks in a palpable way threatens that suspension, making the health issues and health anxieties harder to ignore.
Do picture warnings work? According to Physicians For a Smoke Free Canada, yes. Their web site provides data on the effectiveness of image-based warning labels as well as a worldwide database of smoking labeling campaigns. The images are pretty gory, so prepare yourself if you go a-clicking. It’s sort of shocking to see that all this has been going on worldwide while we Americans been toting around our smartly designed boxes with discreet (and easily ignorable) boxes of text.
You can learn more about the campaign and see the proposed U.S. labeling images here. The FDA is actively seeking feedback on the images, so you can also weigh in with your opinion: Do you think the proposed campaign is doing too much, or too little to discourage prenatal exposure to cigarette smoke?