Graphic Warnings on Cigarette Packages: When Public Health Depends on Public Knowledge
The principles of liberty and personal freedom upon which this country was founded and to which it has ostensibly been dedicated over the course of its history have continually and increasingly come into conflict with other principles, primarily the principle of protection. If it is not the government's job to ensure the protection of its people from both internal and external threats, then there really isn't much of a point to that government. According to liberalist theories, the smallest amount of personal freedoms should be given up in order to obtain the best possible protection, and finding the balance between these two competing ideals can be seen as the fundamental cause of debate and progress in law making and policy enforcement. Some cases are clear-cut -- we have rules of the road that limit personal freedom in order to protect the life and property of others on/along that road, and few would argue that such rules should not exist -- but other cases are more complex.
Tobacco products generally and cigarettes in particular have been a major source of controversy, with an ongoing debate being waged over the right and/or responsibility of the government to legislate cigarette advertising and sales in order to protect citizens form their negative health consequences. The argument that cigarettes should be banned outright is not proposed or seriously defended by many, but the extent to which the government can go in discouraging cigarette use is highly controversial. As the following argument clearly demonstrates, requiring cigarette manufacturers and distributors to place graphic warnings on cigarette packages strikes an effective balance between the need to protect public health and safety and the need to maintain liberty and the freedom of personal choice for American citizens.
Before turning to the specific arguments in favor of graphic warnings, it is necessary to demonstrate that cigarettes are indeed a product that causes a substantial health risk that American citizens and the United States government should be wary of. While it is exhaustively evidenced and generally accepted that cigarettes are bad for one's health, and potentially for the health of those exposed to others' cigarette smoke on a regular basis, this does not in and of itself mean that the products warrant legislative control in order to effectively protect the public health of today's Americans. There are many other products that pose health risks, such as junk food or sporting devices that can cause injury, that do not require graphic warning labels (or warning labels at all), and thus it must be shown that cigarettes present a more substantial and extreme health risk than these other products if government intervention in cigarette package labeling practices is warranted.
According to the Centers for Disease Control, one of the most prominent public health agencies in the United States and indeed in the world, tobacco use is far and away the largest contributor to preventable disease, disability, and death in the United States (CDC, 2012). It is estimated that nearly half-a-million Americans die every year as a direct and sole result of their smoking habit or from exposure to second-hand smoke, while over eight-and-a-half million citizens are living with serious and often chronic illnesses that were caused by their smoking or exposure to second-hand smoke (CDC, 2012). For comparison, in 2009 (the last year for which comprehensive data has been published), there were just shy of eleven million car accidents in the United States resulting in less then thirty-four thousand fatalities -- about one death for every one-hundred-million miles driven by Americans during the year (U.S. Census Bureau, 2011). In other words, despite the fact that many more Americans drive cars than smoke, and despite the fact that there were accident rates that reflect the amount of driving in the country and that show the potential dangers of steering large pieces of metal around at high speeds, far more people were killed by cigarettes (and other tobacco products, though cigarettes are by far the most popular) than were killed in auto accidents (CDC, 2012; U.S. Census Bureau, 2011). Car manufacturers are carefully regulated, drivers are tested and licensed to ensure greater safety and responsibility, and many laws exist governing behavior on the road, and all for products that are clearly less dangerous than tobacco -- surely posting clear warning labels on cigarette packages is consistent with the American ideal of protecting and maintaining public health.
With the real danger that cigarettes and other tobacco product pose is clearly established, and the precedent for controlling the sale and use of products that cause less harm than cigarettes is also quite clear, these arguments do not necessarily add up in a way that supports the use of adding graphic warning labels to cigarette packages. There have been warnings regarding some of the various adverse health effects that cigarettes can cause placed on cigarette packages for more than twenty-five years as a result of previous legislation, and some might argue that any change in these warnings is unnecessary -- the current warnings ought to inform the public to a high enough degree that citizens can make informed consumer decisions regarding their tobacco purchases and use (FDA, 2012). Clearly, however, much of the public is still choosing to use a product that is demonstrably harmful to themselves and to those around them, and this would seem to suggest that the warnings are not as effective as would be desired. No warning will ever be one-hundred percent effective, of course, and while it is the goal of some to eradicate smoking altogether this would not be the goal of incorporating larger and more graphic warnings on cigarette packages. Instead, it is believed that current warnings are not adequately informing the public of the true risks to their health and their lives that can result from choosing to smoke cigarettes, and that more graphic warnings are needed to get this message across and to let consumers make truly informed decisions (FDA, 2012). It is to increase liberty by allowing people to make choices based on the facts that graphic warnings are advocated.
The Food and Drug Administration has already passed a resolution adopting new rules that will require larger and more prominent text-based warnings on all cigarette packages sold in the United States, to go into effect in September of this year (FDA, 2012). Based on their own research as well as evidence from other countries, however, the FDA had actually hoped to implement a policy of graphic warning requirements, as these have been shown to have a much greater effect on smoking cessation decisions than simply larger and more prominent text-based warnings (Borland et al., 2009; Koch, 2011). Because the evidence clearly shows that graphic warnings have more of an effect on actual behavior, it makes sense to conclude that graphic warnings actually present the necessary information to smokers (and others) in a manner that actually inspires conscious thinking in regards to the choices being made, and that is, after all, the goal of such warnings (Borland et al., 2009; FDA, 2012). Given the number of deaths, the amount of disease, and the pure financial costs of smoking -- over ninety-six billion in direct medical costs and ninety-seven billion in productivity loss as a result of tobacco-related health problems -- requirements for warnings that actually have an effect on the choices people make definitely seem to be in order, and graphic warnings are the most effective warnings found (CDC, 2012; Borland et al., 2009).
It could be argued that graphic warnings do more than simply let people know the harm that cigarettes can cause, showing disgusting and scary pictures of damaged lungs and other problems associated with tobacco use. The…