Starting in September 2012, cigarette manufacturers will be required to cover the top half of packages with warning labels that show rotted teeth, diseased lungs and corpses. The Food and Drug Administration predicts the images will reduce the number of American smokers by 213,000 in 2013.
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NEAL CONAN, host: This is TALK OF THE NATION. I'm Neal Conan, in Washington. Starting next year, cigarette packages and ads must include vivid pictures of rotted teeth, diseased lungs and a corpse on a slab after an autopsy. The Food and Drug Administration unveiled nine images yesterday that will take up the top half of every cigarette pack.
If you're a smoker, take a look at those on our website. Go to npr.org. Click on TALK OF THE NATION. Would these labels make you think more about quitting? If not, what would? Give us a call: 800-989-8255. Email us: talk@npr.org. And you can also join the conversation on our website. Go to npr.org. Click on TALK OF THE NATION.
Later in the program, the story of a foul ball and a scapegoat in Chicago - Alex Gibney on his new documentary "Catching Hell." But first, the new cigarette labels. And let's begin with a caller. Tom's on the line, calling from Circleville in Ohio.
TOM: Hi. Thanks for having me on.
CONAN: And have you seen these new images?
TOM: Yeah. They won't make me quit, and they can put them on the packs, because I just take my cigarettes and put them in my own case, anyhow. I enjoy a cigarette. I don't smoke in my house. I don't smoke in my car. If I do smoke, I smoke outside. I also enjoy cigars and pipes. And I really am tired, because the people that smoke know what cigarette smoking does to you.
Okay, I'm just tired of the government getting in my life, and all these self-righteous people that are almost making it illegal for you to even smoke outside, where it'll affect no one because it's out in the open air. And, you know, it won't stop me, simple as that.
CONAN: And Tom, it sounds like there'd be nothing that would make you stop.
TOM: You know, I enjoy it. You know, I've quit other things in my life. I don't drink alcohol. You know, why don't they go after the people with alcohol? How many people get killed by drunk drivers, cirrhoses of the liver and the other diseases, the wife-beating, the child abuse? You don't see a cigarette smoker doing that.
CONAN: There are warning labels on liquor bottles and beer bottles.
TOM: Well, yeah, but do they show - do they show what a liver is? Do they show an abused child? Do they show a beaten wife on them?
CONAN: The - I think the difference is that the FDA was - there was a law passed requiring it to regulate tobacco, and specifically to use these images.
TOM: Well, you know, maybe they should pass a law on alcohol, too. Why don't show all the stuff, you know?
CONAN: All right, Tom.
TOM: You know, I'm just tired of self-righteous people, people that, you know, because they don't like something and they don't like the smell. You know, I'll go out of my way not to offend somebody, but I'm tired of them attacking me all the time.
CONAN: Tom...
TOM: Like I said, I go out of my way not to offend somebody. I don't smoke in my house, don't smoke in my car. I don't smoke where they say no smoking.
CONAN: We've got you, Tom. Thanks very much for the call. Appreciate it.
TOM: All right, you're welcome.
CONAN: Let's turn next to Dr. Margaret Hamburg, the commissioner at the Food and Drug Administration, who joins us from her office in Silver Spring, Maryland. Nice to have you with us today.
Dr. MARGARET HAMBURG: Thank you very much. Glad to be here.
CONAN: And people like Tom, is that who you're trying to get through to?
HAMBURG: Well, we think that we really do have to address the problem of smoking in our nation. It is the leading cause of preventable death. Every year, almost half-a-million people die from smoking and tobacco use, and it also causes enormous amount of disease and disability, not to mention avoidable costs to our health care system and to the economy, more broadly.
We are clearly trying to provide the public with information that they need about the serious health consequences of smoking. We are also, as you mentioned, implementing a law that Congress passed in a very bipartisan way, with an overwhelming majority two years ago, and the president signed into law.
That law is very specific about these graphic health warning labels, the nine text warnings that were to be used on the warning labels and the requirement for color, graphic warning images that would take up 50 percent of the package front and back. So we are implementing the law, and we are trying to have additional impact on a very, very serious public health problem for our nation.
CONAN: How much difference do you expect that these images are going to make?
HAMBURG: Well, we hope that they will make a very significant difference. We know from the experience of other countries that have already implemented graphic health warning labels, that they do very much get the consumer's attention. They increase awareness about the health risks of smoking, that they actually do have an impact on the intent of smokers to quit.
And importantly, we're trying to reach kids that haven't yet taken up smoking, but are at risk if they do start smoking of the addiction and a lifelong habit with deadly consequences. And so for many kids, smoking seems cool and glamorous, but when they pick up a package to try that cigarette and they see the real-world consequences of smoking, they won't think it's quite so sexy, and that's part of what we're trying to convey.
CONAN: I've read based on the experience of Canada, probably the closest analogy to the United States, that the expectation is that something like over 200,000 people would quit on this - would stop smoking over the next couple of years, that at least the projection.
HAMBURG: Well, there have been estimates. And, of course, they're only estimates. But it's been projected that with the introduction of these graphic health warning labels in this country, some 213,000 individuals would stop smoking.
CONAN: That's out of a population, I think, of smokers on the order of 46 million.
HAMBURG: Yeah, so it's not the answer to the entire problem, and as a nation, we really need to have a comprehensive, integrated strategy to address the public health challenge of smoking and tobacco use.
Over the last four decades, we saw steady declines in smoking rates, but in the last five to seven years, since 2004, I believe, the numbers have leveled off, and about 20 percent of the American population is smoking now, adults and young people. And we need to see those numbers to continue to decline. We really do have to recognize that we are suffering - individuals, families, communities and our nation - from preventable disease. And if we can bring down those rates of smoking, we can dramatically improve health for all.
CONAN: Let's get another caller on the line. Corey's(ph) calling us from St. Louis.
COREY: Hi. Thanks for taking my call.
CONAN: Sure.
COREY: I wanted to say, you know, last week, my sister was visiting from Switzerland, and she told me that in Switzerland, they have those images on the packs of cigarettes, and they just flip them over. Now, I looked at the images on your website, and the fact that it would cover both front and back on the packages here I think is a wonderful idea.
I want to say, you know, I'm 34 years old. Both my husband and I have been smoking over 20 years. I have tried everything under the sun to quit smoking. And once I looked at those pictures, my thought was if I had to look at this every time I wanted a cigarette, I wouldn't be able to smoke.
CONAN: Well, Corey, I think you are a poster child - hopefully not on the cigarette pack, but I think Dr. Hamburg would applaud your reaction.
COREY: And, you know, I hope that it goes through and that the appeals that the cigarette - the tobacco companies are talking about and going against First Amendment rights, you know, I think that's bogus. And this should be on our cigarette packs, because I have two young children, and while I do smoke, I don't smoke around them, and I would be absolutely furious if either one of them ever picked up a cigarette.
And I know that with those images, I absolutely would quit smoking. That would be the one thing that would do it for me.
CONAN: Corey, good luck.
COREY: Thank you. Thank you very much.
HAMBURG: The other thing I might mention is that on these graphic warning labels, we also do include a toll-free quit line, 1-800-QUIT-NOW, so that people that do want to explore ways to quit smoking - which isn't always easy, as everyone knows - they will have access to a number that can link them in to services in their state, in their community to help them quit.
CONAN: There will be a court case. As Corey mentioned, the tobacco companies say this regulation is a violation of their First Amendment rights, and they're going to take that to case, and we'll have to see how well they do there.
But there is a sense of aggrievement that we heard earlier from that first caller, the feeling smokers have that they're being persecuted by the government. They're being told what to do, and they're grown-ups, and they can make their own decisions.
HAMBURG: Well, you know, as an adult, he clearly is making his own decision to continue to smoke. He sounds like a very responsible smoker in terms of trying to avoid producing second-hand smoke exposure to people around him.
What we're trying to do with these graphic health warning labels is to provide, admittedly, a very vivid illustration of the actual health risks of smoking. It's one thing to understand a statistic on paper. It's another, I think, to get that powerful image. As they say, a picture can be worth 1,000 words.
I think it is very important. He deserves the information that he - the best information that's available to make a considered choice. If he chooses to keep smoking, that is his choice.
I think when it comes to kids, it becomes a more complex question. And just as the last caller indicated, even though she's been a smoker herself, she'd be very upset if her children started to smoke, and I think that we have to recognize that most smokers in this country today starting smoking before they were the age of 18.
A lot of what we're doing is trying to address the problem of youth smoking, and that these images can have a very important effect reminding individuals who already may know the statistics about what the real consequences look like and helping young people to really understand that smoking has risks.
CONAN: We just have a few seconds left with you. What is the next step after these images?
HAMBURG: Well, these images have now been made available to the companies that produce cigarettes. They will be required to begin to put these images on their products, both the cigarette packages and also on print tobacco - print cigarette advertisements. It's required to take up 20 percent of the top portion of those advertisements. And 15 months from now, as the law indicated, all of those products will have to have these warning labels.
CONAN: Dr. Hamburger(ph) , thanks very much for your time today, appreciate it.
HAMBURG: Thank you.
HAMBURG: ..TEXT: CONAN: This is TALK OF THE NATION from NPR News. I'm Neal Conan in Washington. If you haven't seen the new images that will be soon printed on cigarette packages and ads. You'll find them at our website, npr.org. Click on TALK OF THE NATION. They are graphic: ravaged lungs, a diseased mouth, a corpse. And the FDA hopes they will prompt more than 200,000 people to kick the habit in 2013.
In a few minutes, we'll talk with one writer who doubts that. If you're a smoker, would these labels make you think more about quitting? If not, what would? Our phone number, 800-989-8255. Email talk@npr.org. You can also join the conversation on our website. That's at npr.org. Click on TALK OF THE NATION.
Danny McGoldrick is the president for research at the Campaign for Tobacco-Free Kids, and he joins us here in Studio 3A. Danny, nice to have you with us.
DANNY MCGOLDRICK: Neal, thanks for having me.
CONAN: So you grab smokers' attention with these pictures. Is that enough? I mean, there is information about quit lines.
MCGOLDRICK: There is information about quit lines, and that was a very important decision by the FDA to include that. We of course encourage them to do so in our comments and our partners' comments to the FDA.
I think the research tells us that when you combine an emotional, graphic appeal, sometimes fear-arousing, but back that up with some help, that that's the most effective way to communicate with smokers.
CONAN: Who funds those quit lines? Where are they located? Are they state or federal?
MCGOLDRICK: The 800-QUIT-NOW number gets you to your state quit line. Every state now, fortunately, has a quit line. And so you call that number, and by virtue of where you call from, you are routed to the appropriate quit line.
And they provide services such as, you know, telephone counseling services, where you can call them at various times, or they'll even proactively call you. Some states, depending on how well they're funded, also offer free or reduced-price medications that help people smoke. So it's actually getting people to the evidence-based interventions that enhance the probability that they'll succeed in quitting. It's very important that that's a part of these warning labels.
CONAN: And how successful - the United States has been late into this game. There are many other countries that have very graphic and even more graphic images than the ones that are going to be on the U.S. cigarette packs next year. How well have these campaigns worked elsewhere?
MCGOLDRICK: Well, there's been a fair amount of evaluation, a growing literature on the effectiveness of graphic health warnings. And what the data show consistently, when we surveyed people before the graphic warnings go on the packs and after and compare those to countries where that didn't happen, what we see is increases in knowledge about the health effects of smoking.
We think everybody knows it, but they don't. But increases in intentions to quit, as well. And so they've shown that they do reach smokers and affect them in a positive way. And it's not going to get every smoker to quit. Like your caller earlier might not ...
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