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Outrage of the Month: Court Allows Big Tobacco to Hide the Graphic Dangers of Smoking

Health Letter, January 2013

By Sidney M. Wolfe, M.D.


If you’re not outraged,
you’re not paying attention!

Read what Public Citizen has to say about the biggest blunders and outrageous offenses in the world of public health, published monthly in Health Letter.

We are sure you have already heard some of the government-issued facts on the deadly risks of smoking cigarettes, but they bear repeating.

Tobacco use, the leading preventable cause of death, is responsible for about 1 in 5 deaths annually, or about 443,000 deaths per year. (An estimated 49,000 of these are due to secondhand smoke exposure.) Smokers die an average of 13 to 14 years earlier than nonsmokers. Societal health costs of smoking are estimated at more than $193 billion a year ($96 billion in health care expenditures), with an additional cost of $10 billion for secondhand smoke.

You would think that in the face of this frightening information, the powers that be would do everything possible to further reduce this preventable epidemic. The need for more intervention is clear: Every day, 1,000 people under the age of 18 become daily smokers, and 69 percent of adult smokers wish to quit.

Armed with the recently passed Tobacco Control Act, the Food and Drug Administration (FDA) has, in fact, attempted to deter smoking by proposing that alarming, graphic warning labels appear on cigarette packaging. One of the nine mandatory warning labels proposed by FDA includes an image of a man exhaling cigarette smoke through a tracheotomy hole in his throat, while another shows a plume of cigarette smoke surrounding an infant receiving its mother’s kiss. Such pictures would be accompanied by information highlighting the health risks of smoking and would cover the top half of cigarette packs, front and back.

It should be noted that many countries require much more than 50 percent of space on cigarette packs to be covered with such information. According to a recent Canadian Cancer Society report, dozens of countries require large, pictorial warnings about smoking dangers to cover a majority of the packaging, including Canada (75 percent of the package), Sri Lanka and Uruguay (both 80 percent), and the leader, Australia, with 82.5 percent of the package devoted to these crucial health prevention measures.

But back in the U.S., where our First Amendment has been bizarrely interpreted, resulting in such catastrophes as the Citizens United decision, the extremely harmful industry sued to block the proposed FDA regulation. In the lawsuit, some of the nation’s largest tobacco companies, including R.J. Reynolds Tobacco Co., argued that rights bestowed by the First Amendment protected them from yielding to the potentially life-saving FDA requirement.

What happened? From the headline of this article, you might guess. The deadly monkey wrench thrown by the cigarette industry unfortunately resulted in the U.S. Court of Appeals for the District of Columbia ruling in favor of the tobacco industry. Is this not an Outrage? In our country, the right to sell deadly products unfettered by pictures that would discourage their sale and use has trumped the public’s health.