Introducing Plain Cigarette Packaging in the U.S.

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Despite the numerous and well-documented health risks associated with smoking tobacco, smoking rates in the U.S. continue to be unacceptably high. Tobacco smoking is the leading preventable cause of mortality and morbidity in the U.S., taking the life of one in every two smokers. Smoking is responsible for $170 billion per year in health care costs, almost two thirds of which are borne by taxpayers through public programs such as Medicare and Medicaid.

http://www.cancer.org/research/infographicgallery/tobacco-related-healthcare-costs

Some of the many well-documented health risks associated with smoking tobacco. Source: The American Cancer Society

In 2005, the WHO enacted the Framework Convention on Tobacco Control (FCTC), a treaty aimed at combating the global tobacco addiction epidemic. The convention aims to control the tobacco industry through international regulations, including on tobacco product advertising and restrictions on packaging. Plain cigarette packaging is one solution to minimize people purchasing cigarettes, particularly first-time smokers. In 2011, Australia implemented the Tobacco Plain Packaging Act and has since seen a significant decline in smoking prevalence. Similarly, the UK has just passed regulations for plain packaging despite a high court challenge from the major tobacco companies.

Cigarette Packaging

Australian cigarette packaging before and after implementation of the Tobacco Plain Packaging Act. Source: RCI (Radio Canada International)

Over fifty years has passed since the first Surgeon General’s report on tobacco use, and yet the U.S. still copes with high rates of tobacco consumption. The FDA continues to battle against ‘Big Tobacco’ in legal proceedings in an attempt to regulate the manufacture and advertising of tobacco products. Although the U.S. has been a signatory to the FCTC since 2004, it is yet to submit to the Senate the convention for ratification and therefore has not implemented the framework to date. The burden of tobacco addiction in the U.S is too high. The U.S. should ratify the FCTC immediately and pass legislation mandating the prompt implementation of plain packaging for all cigarettes sold in the U.S.

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4 Responses to “Introducing Plain Cigarette Packaging in the U.S.”

  1. laronjohnsonblog Says:

    Rachvargas,
    I could not agree any more strongly with you that the FCTC should be first ratified and then forcefully implemented in the US and abroad. Diseases from tobacco represent, as you’ve stated, an unnecessarily high burden on the US health system, and it will crowd out investments on any other sector of governmental spending in countries in Africa and China, many of whom have a burgeoning tobacco consumption problem.
    Though plain packaging (PP) is a part of the FCTC framework and should be enforced, PP alone may not suffice in decreasing the prevalence and uptake of smoking, especially in youth. Though smokers from all countries of all income levels do find PP tobacco products less appealing and less desirable than branded products, the lack of preference for PP cigarettes does not deter use. When combined with graphic pictorial warnings however, PP does significantly decrease the incidence of new smoking.
    The durability of the FCTC is that it attacks the tobacco industry from many different strategic points. So order to maximize gains from it, we must follow the multifaceted strategy it lays out. We know that an appropriate level of taxation, complete and enforced workplace smoking bans, and community based smoking cessation counseling and groups all are very effective tools for tobacco control. PP combined with graphic, pictorial health warnings are a vital of the armamentarium in combating the global spread of the tobacco trade.

  2. laronjohnsonblog Says:

    Sorry rachvargas, the hyperlinks didnt come through. Here they are in order though.

    https://www.researchgate.net/publication/282732088_From_directive_to_practice_Are_pictorial_warnings_and_plain_packaging_effective_to_reduce_the_tobacco_addiction

    http://heapro.oxfordjournals.org/content/early/2016/01/29/heapro.dav117.full.pdf?keytype=ref&ijkey=58Av7oGurzOvjwt

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4096613/pdf/nihms574219.pdf

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4502793/pdf/tui-8-2015-001.pdf

  3. angelalamacchia Says:

    laronjohnson, could not agree more. Indeed our group is emphasising only one aspect of the FCTC whilst acknowledging that tobacco control and minimising the health burden of tobacco use requires a multi-faceted approach. I think our point here is that if you had to prioritise which of the aspects to implement from the FCTC due to inevitable limitations to budgets etc. then plain packaging should be a high priority (out of all possible actions) because we know it is effective.

  4. rpalleg1 Says:

    Very important topic. Thanks for posting. I will echo what others have said here in terms of needing a multifaceted approach, but more specifically emphasizing the need for graphic labels. Graphic labels which take up 50% of the packaging on cigarettes have been shown to effectively communicate the health risks of cigarette smoking to many who do not know them (1). This has been shown to decrease initiation of smoking in non-smokers and decrease the amount of cigarettes used by smokers (2). In 2009, the Family Smoking Prevention and Tobacco Control Act (3) became public law which allowed for the FDA to revise cigarette labeling to include graphic labels. In 2011, the FDA launched new graphic labels. Despite the set back of these initial labels being shot down as too disturbing and not factual by U.S. courts, the 2009 law was upheld and FDA still hold the right to regulate graphic labeling. At this point, in 2016, the U.S. is still awaiting revised graphic labels by the FDA — 3 years later. I think an important action would be to urge the FDA to make moves to actually put these graphic label regulations forward, as this seems like an effective, point of purchase way to educate the public and further decrease rates of smoking.

    1. http://www.who.int/fctc/guidelines/ArtElevenHammondOne.pdf?ua=1
    2. http://www.scientificamerican.com/article/plain-tobacco-packs-likely-to-deter-smoking/
    3. https://www.gpo.gov/fdsys/pkg/PLAW-111publ31/html/PLAW-111publ31.htm

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