Smoking is bad.

We hear it from friends and family. We are reminded in public service announcements that second-hand smoke is similar to child abuse and the coughing and shortness of breath after climbing a flight of stairs. Even cigarette packs discourage the use of the very product they contain.

Now, the Food and Drug Administration is requiring all cigarette packaging and advertisements to contain graphic warnings against the dangers of tobacco products. Will grotesque images drive home the message that smoking is bad?

The Warnings

Before September 2012, the Food and Drug Administration will require every cigarette pack to feature gruesome pictures, such as ones that depict a mouth ravaged by gum cancer or someone blowing smoke in an infant’s face. The images, which are paired with health warnings and the 1-800-Quit-Now helpline, are required under the 2009 Family Smoking Prevention and Tobacco Control Act.

The words and images make up the most significant change to cigarette labels in more than 25 years. These new warnings must cover 50 percent of a cigarette pack and 20 percent of advertisements, making it difficult if not impossible for companies to keep their original style or design.

Secretary of Health and Human Services Kathleen Sebelius said that while she hopes these images will affect all smokers, a major motivation is to prevent young people, especially those under 18, to ever start.

“With these warnings, every person who picks up a pack of cigarettes is going to know exactly what risk they’re taking,” Sebelius told reporters earlier this month, according to the White House website. “These labels are frank, honest and powerful depictions of the health risks of smoking and they will help encourage smokers to quit, and prevent children from smoking.”

Thirty-nine other countries have already adopted a similar program, many with even more gruesome pictures than these proposed in the U.S.

Is this legal?

Tobacco companies have to front the bill for the new product warnings. Philip Morris, the country’s largest tobacco company, and R.J. Reynolds, maker of some of the country’s best-selling brands such as Camel, Kool, Winston and Salem, have raised complaints against the new bill.

“Any government requirement that compels a private entity to carry a message not of its own choosing raises constitutional concerns,” Phillip Morris representatives wrote in a federal court document.

The courts ruled in 1985 that not all speech is of equal First Amendment importance. Because certain types of speech, including commercial speech, have “less value” than others, they are not entitled to the full protection of the First Amendment.

Nonetheless, commercial speech has become more protected since the 1970s, said Mark Johnson, media lawyer and chair of the advisory board of The University Daily Kansan. Advertisements have to be for a legal product and have to be truthful, as long as companies uphold those two things, the government cannot ban it, only restrict it.

“Restrictions that work have to be very carefully focused on specific products,” Johnson said. “Tobacco is the main target of advertising restrictions now.”

Last year, major tobacco companies sued and the U.S. District Court in Kentucky had a split-decision but sided with the FDA on keeping the warning labels and many other aspects of the proposal. Some of the FDA’s proposed changes were struck down as unconstitutional, such as a ban on color advertising, most were upheld.

Effectiveness

A Centers for Disease Control study found in 13 out of 14 countries which require similar warning labels on cigarette packs, 25 percent of smokers said they might consider quitting after they saw the graphics. In six of those countries, more than 50 percent said they were considering quitting because of the warning labels. There is no research, however, to indicate how many people actually quit smoking because of the warnings.

Tobacco is one of the leading causes of preventable death in the U.S. and costs approximately $200 billion per year in medical costs and lost productivity, according to a CDC estimate. However, smokers are also some of the most overtaxed citizens who contribute heavily to both federal tax revenues and GDP. In Kansas, .79 cents of every pack goes to taxes, according to the Campaign for Tobacco-Free Kids. In 2008, Kansas collected $118,253 from cigarette taxes and $16,575,613 nation-wide.

It is uncertain yet how the new warning will affect smoking numbers in the future. The overall smoking rate for adults is 19.6 percent. For 18 to 24 year olds the number raises to more than 25 percent. And, according to the CDC, the smoking rate for college students 18 to 24 and in Kansas is 26.4 percent.

Katie Longofono, a senior from Topeka and a smoker for the last four years, said while the new cigarette displays are gruesome, they probably won’t deter her from smoking.

“If you’re addicted to something pictures aren’t going to stop you,” she said. “You’re going to do it regardless.”