Graphic Cigarette Warnings, Differing Views - a Discussion.

I am pleased to see that the Enterprise Record published a couple paragraphs of my recent blog about the new graphic cigarette warning labels in this week’s Blog-Log. I also see that a couple of dissenting views were also published including a lengthy editorial. I always think it is good to look at both sides of an issue. So I thought I would post another blog entry to discuss some of these alternate views.

As a pediatrician, my main concern is in trying to prevent children and teenagers from developing this disease causing, and potentially fatal, habit. It is also in encouraging parents of my patients who smoke to try to stop doing so. Second hand smoke can be horrible for their children to be exposed to. The dissenting arguments in the newspaper were more concerned with government intervention in our lives and civil liberties. The general concern in the media seems to be whether or not if the government can post these very graphic warning images on cigarette packs, what will they decide to post warnings on next. In the editorial, It was suggested that they may next try to put graphic pictures of car accidents on six-packs of beer.

There is, however, a big difference between putting these types of warnings on cigarette packs and alcoholic beverages. In someone who is not prone to alcoholism, drinking alcohol in an appropriate environment (not before getting behind the wheel), can be done in a relatively safe manner. In moderation, alcohol likely provides no great harm. However, if used inappropriately, or in excess, alcohol can be quite dangerous .

The issue with tobacco is that there is no evidence of any beneficial or safe use for it. It can take only smoking a handful of cigarettes to become addicted to them. Once addicted, smoking is a very difficult thing to quit. More and more adults have been quitting smoking of late. If the graphical images can lead even a small percentage of current smokers to work at quitting, or prevent our youth from beginning this deadly habit, the ads will have done their work.

I do understand that many people find the graphical nature of these ads somewhat shocking. However, I think they do a much better job of bringing the potential risks of tobacco use home than the simple text message has been on cigarette packs for many years. Along those lines, I actually think it might not be a bad idea to put graphical pictures of car accidents on six-packs of beer and other alcoholic beverages. There are a tremendous number of accidents, injuries and deaths associated with driving while under the influence. If seeing a graphical reminder of what might happen in that situation stops even a small percentage of alcohol users from getting behind the wheel while intoxicated, think of how many lives may be saved and injuries avoided. Again, the message there would not be against using the product, but rather for using it in an appropriate and safe manner. Reminding people who may not be thinking so clearly because they have drank too much that there might be severe consequences if they illegally drive under the influence is, again, something that is not inappropriate for a government agency to do.

Of course, this type of graphical warning does need to be used in moderation. If overused, it would lose much of its impact. I do not think it likely that we will be seeing graphical pictures of morbidly obese people on pints of ice cream in the near future. Food is necessity for life. If taken in moderation it is, of course healthy and pleasurable for most of us. As already mentioned, however, that statement cannot be applied to tobacco. With the very graphical nature of TV and movies these days, it is becoming ever harder to break through to people and make an impression. My humble opinion is that what the FDA is planning on doing is what it will take to make a difference.

It's About Time: Graphic Warnings Come to Cigarette Packs

Well, it’s about time. After decades of tobacco companies working hard to glamorize cigarette smoking, in some cases blatantly targeting teens and young adults (think Joe Camel), the FDA is finally doing something to show this deadly habit for what it is.

For twenty-five years, cigarettes have carried small, text only, easy to ignore, safety warnings of dubious efficacy. That is about to change.

Yesterday, the FDA released nine pictorial images that will appear as large warning labels on cigarette packs (click here to view). These are pretty graphic and include a mouth with rotting teeth and gums and a person blowing smoke out of a tracheostomy (hole in their neck). Are these exaggerated. I can assure you they are not. I remember rotating at the VA hospital in Atlanta during medical school. Every day I had to walk by a group of veterans smoking in front of the hospital. Invariably, two or three of them were smoking through trach’s and another couple were hooked up to oxygen tanks - it was quite a sad, and shocking, site to see. I also remember rotating through otolaryngology (ENT) and participating in surgeries to remove half of the jaw of someone with mouth cancer or part of the upper jaw and nose of someone else for the same reason.

Fortunately, smoking is decreasing overall. However, quite a few of our older children and teens are getting hooked on cigarettes. This is usually because they think it makes them somehow more adult-like, rebellious or courageous. In reality it just makes them addicted to something that they many or may not be able to ever quit. Something that costs a great deal of money, leads to bad breath and stained fingernails, a smoker’s cough, and eventually to complications such as emphysema, gum disease and tooth loss and mouth, throat, or lung cancer.

Please share these pictures with your children and teens before they take that first drag of a cigarette. You might just be saving their life.


Choice is the Key to Getting Children to Eat More Veggies

United Press International

Two researchers, at the Institute for University of Grenada in Spain and the Universities of Wageningen in the Netherlands looked at vegetable consumption in children under age 6.

They found that if children were left to pick there veggies ate every meal, they ate on average 80% more vegetables.
Some vegetables contain bitter elements such as calcium or sulphur, including broccoli, onions, cabbage, chard or collard greens or spinach can be difficult for some children to eat.

It is very important that children eat their veggies. This is one strategy you, as a parent, can try with your child if they are less than enthused when they appear on the dinner plate.