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getting graphic with tobacco packaging

November 11, 2010

in health communication,tobacco cessation

the FDA’s proposing a rule that’ll require new graphic images for tobacco packaging. and boy, are they stark. one image is of a man who looks like he’s had a tracheotomy. it reminded me of andy garcia in the movie dead again. (if you’ve seen that movie, you know what i’m talking about. no clip of it is available.)

here are a few of the possible graphics. some of them work. but some are so grotesque or histrionic, they’re almost laughable.

cigarettes are addictive - tracheotomoy

new tobacco packaging image

tobacco smoke can harm your children

cigarettes cause canceryou can see the rest here and add your comment, which will be considered along with expert and user opinion before the final images go live on october 22, 2012.

according to some studies, a more graphic approach has been successful in other countries. i wonder how much is due to the image and how much could be because consumers are embarrassed to buy a product that looks like this. shame is a mighty influencer.

notably, dr. richard d. hurt, director of the nicotine dependence center at the mayo clinic commented that “higher federal tax and tougher workplace restrictions were also needed.”


for a roundup of news commentary, read this.

Leave a Comment

{ 15 comments… read them below or add one }

Nedra Weinreich November 11, 2010 at 2:43 pm

I have mixed feelings about these. On the one hand, it’s not like smokers don’t already know these facts. Using such a fear-based approach may backfire and only strengthen their resistance to quitting. On the other hand, as you said, research is showing that this approach is effective in other countries, so perhaps it will work here too.

Some of these graphics are definitely stigmatizing – particularly the ones that show the effects of smoking on their kids and other people. But any cigarette package is already a signal that someone is engaging in this behavior that is mostly not socially acceptable.

I think a new product line of cigarette pack covers will flourish, or manufacturers will figure out a way to make it easy for users to tear off or flip over that part of the package. I’m skeptical that this will make much of a dent.

BTW, my first thought when seeing the cartoon with the text “cigarettes are addictive” was “Why is that guy sticking a cigarette into his belly button?” Took me a minute to figure out what the image was.


fran November 11, 2010 at 4:48 pm

nedra, that image of the guy “shooting up” with a cigarette is one of the few i like. the fact that the image didn’t connect with you proves the importance of testing communications with your intended audience!

your ideas about the manufacturer’s workaround is interesting. i hadn’t investigated how easy it might be to override the FDA ruling.

i’m not sure what type of dent it’ll make, either. what andrea says below about the cache teenagers attached to collecting the images is disappointing. if these images halted a younger generation but didn’t nudge the current generation of smokers, that’d be a plus in my book.



Nedra Weinreich November 11, 2010 at 7:14 pm

As someone who doesn’t smoke, I definitely am not the target audience. But I sure hope that they either have or will test these out before finalizing the choices.


Andrea Hill November 11, 2010 at 7:15 pm

So here’s a question for you – what would be your desired outcome from testing? The more people dislike it, the more effective it is, right?


Nedra Weinreich November 11, 2010 at 7:59 pm

Like or dislike is not really the important measure when you’re pretesting. You want to look at criteria like comprehension, relevance, appropriateness for the audience, credibility, noticeability and – most importantly – whether there are changes to the audience’s knowledge, attitudes and intended behaviors after seeing the graphic.

I sure hope that the FDA will spend the time and money to get this right by getting feedback from smokers, rather than just relying on what appeals most to those of us who may have a completely different (and in this instance irrelevant) set of values, attitudes and behaviors!

fran November 12, 2010 at 10:40 am

the article suggests that they are testing with their users, as well as with “experts.”


Andrea Hill November 11, 2010 at 2:53 pm

Growing up in Canada, I’ve long been exposed to graphic cigarette packages. The plan actually backfired as youth took to collecting the different packages.

Again in Canada the approach to messaging was subtly different. Rather than focusing on the health impacts on the smoker itself, the approach was on the impact to others (family, children, etc). The idea was that if a smoker did not care about how he was harming himself, he may reconsider how he’s harming those he cares for.

But despite this messaging AND high taxation, people still smoke.


fran November 11, 2010 at 4:49 pm

andrea, thanks for sharing what you saw in canada. it’s really disappointing to hear that teens turned it into a game of sorts. is there data on that?



Jose M Sanchez November 11, 2010 at 3:47 pm

They have tried everything in campaigns against smoking. From simple warnings on cigarette boxes to the testimony of big stars of the TV, through ingenious jewels advertising creativity. But the results were not satisfactory.

I agree with Nedra, It’s time to realize that smokers already have the knowledge about the facts and consequences for smoking, it’s nothing new for them to show a (horrifying) picture in the packages.

Do you remember what happen in Brazil? In 2003, the Ministry of Health of Brazil forced tobacco companies to include warnings on an entire face of each carton of cigarettes. These warnings were crude images showing some lungs with cancer, and so on… you can imagine… some very creative I can tell you, not so cartoonish as above.

Ahh, and other thing… a higher federal tax, maybe will help, but the smoker will be always smoker, so it’ll fing a way to smoke. Here in Mexico, the goverment is propoising a higher federal tax for the cigarette box… the final price is like paying a complete ecomonic meal. So… that hurts, but it make a difference?

I think that is ok, but as with all addictions, should be completed this education campaign in schools, and naturally at home. Education is the panacea of all social marketing communications.


fran November 11, 2010 at 4:58 pm

jose, thanks for chiming in. i think education is only a part, honestly. if it’s the panacea, then wouldn’t smokers not smoke? because, as you say, they know the dangers. seems like we may need to push from several angles – taxation, workforce changes, vehemently guarded policy change (e.g., bans on smoking in bars, marketing) – to change public perception and to keep moving down the dial. i’d actually like to know what’s an acceptable population of tobacco users.



Jose M Sanchez November 11, 2010 at 7:16 pm

well that’s the point… do we really know the insight why smorkers smoke? really? Give three insights from them considering that they already know the health risks which may generate, and not only them but for others … there will be one to tell us “from something I’m going to have to die “, but why continue to smoke despiteall efforts there as taxes, counter-marketing,

Yes I know, it must be an integrated campaign, 360º effort….

I was coordinating the communication campaign for “Smoke-free spaces” in Mexico, and let me tell you this: It was hell. Literally. Companies, media, civic associations … everywhere negative things you heard on this measure … “How you leave smokers out of bars, restaurants?, Sales were lowered?, Businesses will close for this measure?” etc… -yeah it was nos a short, it was a long term of communicate, educate and do. But in the end… well… the people know that this measure was for the benefit (health) of everyone.

So, what I meant about education, is that sometime we forget about that, we as marketers we are really excited about the communicative, visual, leaving a good message, but there is a cognitive process to generate real change.

I made a keynote about social (behavioural) change, if you want to look for it here is the url: http://www.slideshare.net/josemsanchez/social-marketing-how-to-make-change-happen
You’ll find interesting the 7 steps of social change.

Thank you again for your comment 🙂


Jose M Sanchez November 19, 2010 at 6:17 pm

Just to keep in touch,
In last week, there’re some new graphics in some tobacco packages,
here are the images:
– Front: http://www.twitpic.com/38a4bz
– Back: http://www.twitpic.com/389mbx
I don’t get it.. why we are still using negative and dramatic messages to prevent people from smoking?
Evidence says that using negative/impositive messages only make a reaction (short term), but not a real behavior change… so… well… I’m still guessing if this kind of campaigns are really for a long and absolut change.. or only temporarily.


Andrea Hill November 11, 2010 at 5:05 pm

I don’t have any findings on the effectiveness, just first-hand observations 🙂

But – here are some of the images from Canadian packaging. These types of warnings have been there since 2000: http://www.smoke-free.ca/warnings/Canada-warnings.htm

And a report from 2002 on exploring the “the similarities and differences between Canadian and American cultural environments” in “Designing a “Made for Canada” Approach to Federal Tobacco Control Mass Media” – http://www.hc-sc.gc.ca/hc-ps/pubs/tobac-tabac/media/culture-eng.php


Leah Roman November 15, 2010 at 11:47 pm

Thanks for posting. I think these images (and other fear based messages) will be ineffective for prevention. You can check out my argument against these graphics in my post on my blog Pop Health: http://www.pop-health.blogspot.com/

Thanks, Leah


fran November 16, 2010 at 7:48 am

leah, thanks for sharing your post. and for introducing me to your blog. i agree that more will come from environmental and policy change. we’ve actually come a long way, if you look at this chart from gallup in an earlier post on tobacco free acceptance: http://bit.ly/dknh5E



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