Smokers should get graphic warnings of their risks

It’s one of the most addictive and lethal drugs that humans abuse, killing far more Americans every year – 440,000-plus – than all illegal drugs combined.

Tobacco – specifically in its most popular delivery system, cigarettes – also plays a major role in rising health costs. Lawmakers and health officials know they can’t outlaw tobacco; about 20 percent of American adults are addicted to it. So they’re trying to do the next best thing: Prevent as many young people from getting hooked and persuade as many smokers as they can to stop.

The best way to do that is to make cigarettes expensive; smoking rates drop a little every time cigarette taxes go up. But another strategy has been found effective in more than 20 countries: graphic health warnings on cigarette packages – ones so big, colorful and disturbing that smokers can’t miss them.

The Food and Drug Administration has proposed nine such graphic warning labels to be placed on cigarette packages beginning this fall, along with a stop-smoking hotline number.

But the tobacco industry is fighting that requirement in a federal appeals court, saying it goes beyond factual information into anti-smoking advocacy. An earlier court had ruled in Big Tobacco’s favor.

As the federal agency tasked with regulating tobacco products, the FDA should advocate for less smoking. Even nonsmokers pay for smoking, through higher health care costs and lost economic productivity – an estimated $193 billion per year. It’s the leading preventable cause of disease, disability and death, and this addictive, lethal drug certainly would not be legal if it were just coming on the market today.

The images on graphic warning labels vary from country to country, but the result is the same: They work. Take Thailand, for instance. After it started running the labels, the percentage of smokers who said that the warnings made them more likely to quit rose from 31 percent to 46 percent.

During that same period in Malaysia, which ran small labels similar to ones that appear in the United States, smokers reported they were actually less likely to quit. The FDA estimates the new labels would discourage more than 200,000 U.S. smokers in the first few years after they appear.

Some critics say that the labels don’t tell people anything they don’t already know, that smokers are aware that they risk lung cancer and as consenting adults don’t need the government playing nanny.

But studies show that many people aren’t aware of all of smoking’s health risks, which include oral cancer, heart disease, stroke and fetal damage. Graphic labels can provide more information than small written messages and make cigarette packages less attractive. Every time a smoker picks up the package, the health-risk message is reinforced. For at least some smokers, that can lead to reduced smoking or quitting.

Commercial speech has never enjoyed the same level of constitutional protection as individual speech. The court hearing this case should rule in favor of Americans’ health, not Big Tobacco’s profits.