Aimee Schiefelbein, Quit Coach, Service Delivery:

Last December, New York City became the first U.S. city to require stores to post 4-square-foot warnings showing the physical effects of smoking near tobacco displays and smaller ones near check-out counters. Last month, a few retailers and the three big companies (Lorillard, R.J. Reynolds, and Philip Morris) filed a lawsuit challenging the New York Board of Health, claiming the regulation violates the First Amendment by requiring tobacco sellers "to undertake graphic advocacy on behalf of the city." In other words, the tobacco companies don't want you to realize what you are doing to your body because if you had a visual, if you heard the words, and if you read the warnings enough times you might quit.

This spring, Massachusetts appeared likely to become the first state to force retailers to prominently display graphic warnings about the health impact of cigarettes. Yet while members of the Public Health Council expressed support in advance of the planned vote, state officials now wait to see what happens in the pending New York lawsuit. The delay keeps Massachusetts from setting a precedent that could significantly decrease tobacco sales.

Why would this tactic work? Imagine for a moment: you smoke a pack a day. Your mother died of lung cancer and you were just diagnosed with COPD (Chronic Obstructive Pulmonary Disease). Intellectually you know quitting smoking is the best thing you can do for your health. You have gotten so used to cigarettes being a part of your life that you hardly notice you get winded quicker than normal because this is "normal" for you. You think, I'll quit eventually, I just need to get through the stress at work. You have all the reasons in the world to stop smoking but there is only one problem; you don't know if you want to. Part of this is because you can't see the long term benefits you would gain by quitting. You can't open up your chest and see the damage you have done to your lungs. You read the surgeon general's warning on a pack of cigarettes that says "Tobacco Smoke Increases the Risk of Lung Cancer and Heart Disease" and to you they are just words. You think to yourself, we're all going to die eventually so why not enjoy myself?
 
Later that day you enter a convenience store and while standing at the counter to buy your next pack of cigarettes you see a life size picture of a darkened and diseased smokers lung. Suddenly you feel a pit in your stomach and you recognize that this picture you are looking at is what you are doing to yourself. There is nothing left to the imagination, there is no way you can deny it. It's not just words on a pack of cigarettes; this is you. You picture your children and grandchildren living on without you. You say to yourself, I will die soon if I don't do something. You throw the cigarettes back on the counter and walk out, proclaiming your desire not to be enslaved by cigarettes any longer.

I wish every state would display graphic images of diseased lungs, rotting teeth, and damaged brains with the urge to quit tobacco. Not that I particularly want to see this as I am going to pay for my gasoline at the convenience store; in fact, it turns my stomach to look at some of the sample posters. However...I do believe these graphic images could prevent that person who is buying their next pack to think about their choice before they follow through. I think of a teenager going in to buy their first pack, only to be confronted by the reality of how smoking could impact their appearance. I think of my family members who struggle with their tobacco addiction, hoping maybe it will encourage them to quit too.

Will graphic displays actually help? Only time will tell. I do know one thing; we are bombarded every day with smoking advertisements. It's about time we see more concrete education challenging the tobacco industry.