The Food and Drug Administration (FDA) has concluded that years of warnings about the dangers of smoking cigarettes, the availability of nicotine patches and gum has not worked.  Instead, the FDA is proposing to put gruesome images on cigarette packs that warn of the consequences of smoking.  Tobacco is the leading cause of early and preventable deaths in the United States, accounting for 433,000 annual deaths and approximately 33 percent of all cancer deaths.  The healthcare reform law provides free access to anti-smoking therapies; the stimulus bill included $225 million to support local, state and national anti-smoking programs.

The proposed images, which include one of a man suffering a heart attack and another of a mother blowing smoke in her baby’s face, would cover half the front and back of each pack if adopted.  “When the rule takes effect, the health consequences of smoking will be obvious every time someone picks up a pack of cigarettes,” said Margaret A. Hamburg, FDA Commissioner.  The FDA plans to choose nine images by June 22.  After October 22, 2012, cigarette manufacturers who refuse to put the new warnings on their product will be banned from selling their brands in the United States.  Anti-tobacco activists applauded the move.  “In implementing the new warnings, the United States is catching up to scientific best practices,” said Matthew Myers of the Campaign for Tobacco-Free Kids.

Not surprisingly, some tobacco companies are not thrilled.  R. J. Reynolds Tobacco Company, which is already suing the government over tobacco regulations, is reviewing the proposed warnings.  “It is worth noting that the legality of requiring larger and graphic warnings is part of our lawsuit that is currently pending,” said company spokesman David Howard.  Philip Morris USA, on the other hand, has been supportive of FDA regulations; the company “has actively participated in the FDA’s rule-making and public comment process and plans to do the same on this proposal.”

Canada, which has used graphic warnings since 2000, has seen a significant reduction in smoking.  “It’s always difficult to point to a particular policy and say it’s due to that,” said David Hammond, a researcher of the University of Waterloo in Ontario.  In fact, smoking rates in Canada have fallen approximately 20 percent since 1985.  “But all the evidence does point to the fact that these things do help.  The bottom line is that there’s no magic bullet.  But about one-third of smokers say this increases their motivation to quit, and about the same proportion of former smokers say they remind them why they quit.”