U.S. - Graphic labels for cigarette packs are three years away..

July 11, 2009 - The new law requires stark, black and white labels covering half the pack with warnings such as “Cigarettes cause cancer” or “Smoking can kill you.“

The U.S. government's new tobacco regulations spell out the words, size and color of new cigarette warning labels -- but despite much publicity about tough new warnings, don't expect to see any for three years.

Some public-health advocates worry it's a sign that federal action to cut smoking will come only slowly and cautiously -- a concern they'd had ever since the nation's No. 1 cigarette-maker, Philip Morris USA, came out for regulation nearly a decade ago.

But it also calls for warnings with color images, giving the U.S. Food and Drug Administration two years to come up with guidelines for them. Cigarette-makers would then have 15 months to start putting new warning labels on packs. That means that it won't be until 15 months after the graphic-warning guidelines are published, in June 2011, that any new warnings will appear on packs, FDA spokeswoman Siobhan DeLancey said. Officials of both Philip Morris USA and the Campaign for Tobacco-Free Kids, which backed the legislation, confirmed that timeline.

Michael Siegel, a Boston University medical professor and tobacco-control advocate: "Evidence shows that while the warning labels may have a short-term impact, after a while people become used to them and don't pay attention anymore."

The warning labels specified in the bill -- covering half the front of a pack with warnings printed in letters roughly 3/8-inch high -- would be bigger than the text-only labels on British cigarettes, which cover about a third of the front of the packs. The new U.S. cigarette warnings, unlike the current warnings on the side of packs required since 1985, say cigarettes and smoking cause disease, not that they may do so.

The law also calls for eventually using graphic warnings, as Canada has for several years and as Australia started doing in 2006. Both countries use images of often luridly colored cancer-damaged tissue, while one Australian warning shows a baby on a respirator. The images are on both the front and back of the packs, so they are harder for smokers to hide.

A new study shows that Australian smokers noticed and read the new graphic warnings more than they had text-only labels and that the proportion who decided not to smoke at least one cigarette because of the warning roughly doubled. The study showed Americans notice the current warnings rarely, while Canadians notice theirs sometimes and Britons a bit more often than the Canadians. "There is no doubt that the bigger and more contrasting the warnings, the better for discouraging smoking and encouraging quitting," said the study's lead author, Ron Borland, of the Cancer Council in Melbourne, Australia.

RESEARCH PAPER: Impact of Graphic and Text Warnings on Cigarette Packs: Findings from Four Countries over Five Years; Ron Borland, Nick Wilson, Geoffrey T Fong, David Hammond, K Michael Cummings, Hua H Yong, Warwick Hosking, Gerard B Hastings, James Thrasher and Ann McNeill; Tob Control. Published Online First: 28 June 2009. doi:10.1136/tc.2008.028043; ABSTRACT...

The finding in an Australian study suggest that the introduction of graphic warning labels may help to reduce smoking among adolescents.

Danny McGoldrick, vice president for research at the Campaign for Tobacco-Free Kids, a backer of the new legislation, said it is better to wait for graphic warnings like those used in Canada and Australia than to go ahead immediately with the text-only ones. "I think this shows how we want to go forward with evidence-based policy," he said. McGoldrick said language implementing the text-only warnings as an interim measure was left out as the House and the Senate worked to reconcile their versions of tobacco-control law after they were hurriedly adopted last month.

Alan Blum, director of the University of Alabama Center for the Study of Tobacco and Society: I can't recall a bill with so little give and take." "This was rammed down people's throats because of the deal they made with Philip Morris," he said. "In my opinion, there's this inside-the-Beltway mindset . . . saying, 'I don't care about the details, I'm going to get this bill through.'"

Altria Group, which owns Philip Morris USA, broke with the rest of the industry to support FDA regulation. Critics such as Blum believe the company's strategy is to use regulation to consolidate its hold on the market, but Altria said it believes regulation will encourage competition, including from tobacco products that are alternatives to cigarettes. For now, Philip Morris USA spokesman Bill Phelps said of the warning-label requirement: "It is too early to speculate on what these changes will entail from a manufacturing perspective."

Reference: Graphic labels for cigarette packs are three years away by David Ress, Richmond Times-Dispatch, 7/11/2009.