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.
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