- About 120 other countries require disturbing images to be placed on cigarette boxes
- The cigarette companies argued that the US rule requiring this violates the right to freedom of expression
- READ MORE: US finally forces smoke shops to post health warnings on cigarettes
Boxes of cigarettes sold in the US could soon be plastered with 11 images depicting the damage of smoking, including amputated limbs and neck tumors.
Tobacco companies had argued that mandating the warnings – which have been common practice in Britain and Europe for years – violated their right to free speech because the images, according to the manufacturers, misrepresented the harms of smoking.
But the Fifth Circuit Court of Appeals ruled in the government’s favor, saying the images — which included amputated toes and rotten lungs — were “both factual and uncontroversial.”
The decision is a victory for the Biden administration — which is also considering banning menthol-flavored cigarettes — and could make the warnings mandatory in coming years.
The warnings included a photo of a woman with a large growth protruding from her neck and the caption “WARNING: Smoking causes head and neck cancer.”
Another shows a man’s torso with a long scar from surgery and a warning that says, “Smoking can cause heart disease and stroke by clogging arteries.”
Other images show a baby whose fetal growth was stunted and feet with amputated toes caused by poor blood circulation.
The FDA said the warnings were justified by the government’s interest in promoting better understanding of the health risks of smoking and reducing confusion and deception.
Tobacco companies countered that the warnings went far beyond text warnings allowed since 1984, including that smoking causes lung cancer and quitting smoking reduces health risks.
Some companies that fought the rule included RJ Reynolds, ITG Brands and Liggett Group.
However, in a 3-0 decision, Judge Jerry Smith said the explicit warnings conveyed facts about the benefits of cutting down on smoking and were not unconstitutional because they may “arouse emotions” or relate to ideological or political concerns.
Some studies have shown that the warnings can deter people from smoking, although the evidence is mixed
Cigarette smoking kills approximately 480,000 Americans every year
Lindsey Powell, a representative for the FDA, said stirring up emotions “doesn’t push them over the line to make them controversial… Some of the facts are troubling.”
Cigarette smoking causes approximately 480,000 deaths annually in the United States.
The ruling overturned a lower court ruling by a Texas judge who sided with the tobacco companies.
An FDA rule adopted in 2020 under the Trump administration required warnings about the risks of smoking to cover the top 50 percent of cigarette packs and the top 20 percent of advertisements. The labels would contain eleven graphic images to illustrate the risks of smoking.
Nearly 120 countries around the world have adopted larger, graphic warning labels. Some studies in those countries have shown that the warnings have had some effect in reducing the number of smokers and encouraging more smokers to quit.
A 2020 study by researchers at the University of North Carolina found that putting images on cigarette warning labels is harmful increases the probability that smokers would quit. Yet images do not necessarily change people’s views about the risk of harm.
They found that showing people warning signs, such as yellowed teeth and diseased lungs, caused immediate emotional responses, including fear, sadness, guilt and disgust.
They were more likely to think about the health risks associated with smoking. But despite their effectiveness in motivating smokers to quit, picture warnings failed to change viewers’ beliefs about the likelihood or severity of negative health consequences.
At the same time, researchers at the University of California, San Diego found that smokers who received packages containing pictures of sick feet, sick children and throat cancer continued to puff about ten cigarettes every day for a year after receiving them.
Six in 10 admitted to hiding the packages at least some of the time because of the images, which was 40 percent more than before the survey began.