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Stanford chair of otolaryngology discusses federal court's ruling on graphic cigarette labels

Earlier this week, a federal judge declared unconstitutional new rules that would have required tobacco companies to display graphic images on packs of cigarettes.

At issue were regulations published by the U.S. Food and Drug Administration last year mandating tobacco companies affix large warning labels to cigarette packages, cartons and advertising. The labels, which are meant to shock consumers and dissuade them from smoking, include images such as a man exhaling cigarette smoke through a tracheotomy hole.

When I read about the ruling, I contacted Stanford Chair of Otolaryngology Robert Jackler, MD, whose ongoing research into the history of tobacco company advertising has resulted in several published studies, to get his thoughts. He responded:

Judge Leon's decision states that the graphic images mandated by the FDA are "neither factual nor accurate." However, it is an indisputable fact that smoking causes an enormous toll of both disease and death - indeed it is the leading cause of preventable death in America. It is hard to imagine what logic could consider a visual depiction of tobacco caused diseases such as lung cancer and heart attack anything but factual and accurate. The images resonate with my first hand experience as a physician and, no doubt, that of innumerable families whose loved ones have suffered the tragedy of tobacco caused disease.

Judge Leon ruled the graphic warning "unconstitutionally compelling speech." Using this logic, does he advocate banning the skull and crossbones traditionally placed on deadly poisons and replace if with a small and inconspicuous typeface placed discretely on the side of the bottle? The fact that text warnings are notably less effective than visually striking ones is the reason that the tobacco industry prefers them. Over 40 countries around the world require large, visually compelling, graphic warning on tobacco products often using imagery considerably more striking than those adopted by the FDA.

Congress passed the Family Smoking Prevention and Tobacco Control Act of 2009, which assigned oversight of tobacco to the FDA. In Sec. 201 it states: Cigarette package health warnings will be required to cover the top 50 percent of both the front and rear panels of the package, and the nine specific warning messages must rotate randomly over the course of the year. These messages must be accompanied by color graphics showing the negative health consequences of smoking cigarettes.

Previously: Hey doc, got a light? Research highlights Big Tobacco's long history with the medical community, The smoking gun of the Iron Lady: Margaret Thatcher's relationship with the tobacco industry, Throat doctors manipulated by Big Tobacco and NPR's Picture Show highlights Stanford collection of cigarette ads, Image of the Week: A new cigarette warning and A conversation about the FDA’s new graphic health warnings for cigarettes
Photo by C.K. Koay

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