Surgeon General Warning on Tobacco

Warning Labels

Not even 50 years ago, many people felt skeptical about the hazards of cigarette smoking. Although increasing numbers of studies showed that some connection existed between tobacco and lung and heart ailments, questions still remained about the true effects on health. In 1964, however, the United States Surgeon General Luther Terry confronted 200 media reporters in a State Department auditorium for two hours and completely changed the course of history. For the first time, the American government made it official: Smoking causes lung cancer. How much of an impact did this warning and other warnings to come by the Surgeon General and additional interested parties in the future alter the numbers of people smoking nationwide? The results are not too promising.

After the Surgeon General's first announcement, there was an immediate reaction. At this time, about 46% of people smoked in the U.S. When Americans heard the Surgeon General's words of warning, they decreased cigarette consumption by 20%. In addition, the number of individuals actually smoking fell as much as 30%. Research found that the vast majority of smokers believed their habit would harm their health. However, the reaction did not last long. The following year, more than 42% of adults were still smoking. This was despite the fact that the 1965 Federal Cigarette Labeling and Advertising Act required U.S. Surgeon General's warnings on all cigarette packs (Bowman).

Congress twice strengthened the labeling requirement. First, in 1969, it stipulated "Warning: The Surgeon General Has Determined that Cigarette Smoking is Dangerous to your Health," a significant upgrade from the 1965 "may be hazardous" wording. Next, in 1984, Congress went further and required that four different warnings be rotated. Each warning would be preceded by the phrase "Surgeon General's Warning.": 1) Smoking Causes Lung Cancer, Heart Disease, Emphysema and May Complicate Pregnancy; 2) Quitting Smoking Now Greatly Reduces Serious Risks to Your Health; 3) Smoking by Pregnant Women May Result in Fetal Injury, Premature Birth and Low Birth Weight; and 4) Cigarette Smoke Contains Carbon Monoxide" (Derthick,15).

Do smokers feel they are at risk when seeing these labels? Study results conflict. Some researchers have found that smokers overestimate the health risks of smoking. Such results challenge the belief that people begin and continue smoking in large part because they do not accept the risks. Other scholars, however, who use different questions to measure risk, conclude that smokers either accurately estimate or underestimate their risks (Weinstein, 135). Such conflicting reports do not come as a surprise. It is often found that research results will vary significantly depending on a number of different factors.

It is understood, however, that the majority of smokers clearly do acknowledge some risk, but they minimize the size of that risk and show a tendency to believe that the risk applies more to others than themselves. Bottom line: People do not want to believe that they will be the one impacted. Instead, it will be the guy/gal next door.

The findings of Romer and Jamieson are not any more positive. They looked at studies that researched how anticigarette advertising counteracts the favorable images of smoking pushed by the tobacco industry. They stated, " ... even if anticigarette advertising increases perceived risk, the overwhelming influence of tobacco industry advertising and promotion acts to increase favorable images and feelings associated with smoking. These images and feelings then reduce the perception of risk."

Levy adds to these grim statistics. He states that despite the mass media's extensive coverage of the findings of the U.S. Surgeon General and other research, not too many people (only 16% according to an American Cancer Society survey) believe that there is a correlation between cigarette smoking and lung cancer. This can be the result of a number of different factors. Perhaps the mind rejects the message or, never receives it. In the past 10 years, over 100 billion cigarettes have been sold domestically. Decreases in smoking consumption have only declined twice in two years since 1935: 1953 and 1954, the years following the publicity given the cancer studies. As soon as the tobacco industry began a campaign regarding the reduced risks of filtered cigarettes, the tide changed once again.

Another reason why warnings and labels may not work as well as hoped is that scientists are still learning about people's decision making processes. For example, a great deal of evidence suggests that individuals tend to begin the decision process with a desired belief already in mind (Hanson & Kysar, 231). Their "scientific" reasoning thus consists of looking for evidence and explanations to support this prior belief. This "cognitive" belief, is of course, in direct odds with the true scientific approach that looks at all facts on both sides and then comes up with a conclusion.

Further, individuals, especially youth, are apt to overlook warnings and other negative information in order to gain better results from another behavior. Cigarette manufacturers try to make their products seem acceptable to the peers of potential smokers. They also offer their cigarettes to young people as a means of identifying and joining a peer group to which the potential smoker may otherwise lack access. Given a climate of rejection/ostracism:

Smokers want to belong and feel that it is acceptable to smoke (Camel).

Being rebellious and outspoken helps to keep criticism at bay.

Camel gives the smoker a lot of excitement and involvement at a time when they need to feel better about themselves.

Camel offers this age group a peer group which feeds their need to belong.

Until other ways present themselves to reduce smoking, such as actually being able to ban tobacco usage (and one can be quite sure that will not ever happen, and it is debatable whether banning should even be a consideration), warning labels are still one means for at least making people aware of the dangers and/or stopping them from smoking for a time, even if they resume the habit in the future.

Some researchers in Canada, in fact, decided to make sure that people cannot ignore the labels. University of Waterloo professor Geoffrey Fong, of the Department of Psychology, is leading a research team to examine the effects of unique warning labels among high school students. Since December 2000, Canadian cigarette smokers have been encountering the world's largest and most graphic warning labels. The labels cover 50 per cent of the principal display surface, front and back, of tobacco packages. Many include vivid photographs of some of the ravaging consequences of smoking.

But will these large warning labels have a better impact than the smaller ones?

"Virtually everyone has an opinion about the warning labels," Fong said. "It's easy to come up with reasons why the warning labels would work and it is easy to come up with reasons why they would not work. But which is true? That's what we're trying to find out in this study." Since about 90 per cent of adult smokers began smoking as teenagers, Fong and his research team are surveying students at nine high schools throughout Canada over a three-year period, with the first wave of surveys conducted before the new labels were introduced to establish a baseline. In addition, as a control, six high schools in the United States, where cigarette labels have not changed, are also being surveyed. In all, more than 12,000 high school students are participating in Fong's study.