(Debora Cartagena/Black Press Media)

(Debora Cartagena/Black Press Media)

Cigarette packs with graphic images, blunt warnings are effective: focus groups

Warnings considered effective flag ailments smoking can cause, like colorectal and stomach cancers

One image shows a woman’s torso with a cigarette being burned into her bladder through underwear.

Another depicts a man holding a colostomy bag, adding the words, “You may need to use a bag as a toilet for the rest of your life.”

There’s also a naked man holding a sign over his lower body that says, “out of order.”

The federal government is testing graphic new warnings to wrap around cigarette packages, and the stark message is clear: smoking is bad and it can damage more than your lungs.

The proposed warnings, shown to focus groups across the country, are meant to reinforce what people already know about cigarettes and add information that’s less widely known.

Canadians reported that cigarette packages with graphic images and pointed health warnings are more effective than cliches or rhyming slogans.

The health warnings considered most effective flag types of ailments smoking can cause, like colorectal and stomach cancers, as well as oral diseases and damage to blood vessels. The warnings are accompanied by explicit images showing real people who are suffering from the problems.

Youth smokers and non-smokers, as well as young adult and adult smokers were asked to assess mock-ups of 39 potential health warnings for cigarette packages and 11 potential taglines to accompany them, which include contact information for those wishing to seek help.

Focus groups were held last winter in Halifax, Toronto, Vancouver and Quebec City.

The government’s planned Tobacco Products Labelling Regulations currently require 16 rotating health warnings on packages of cigarettes and little cigars, though that number could change when the labelling regulations are amended.

Youth participants, aged 15 to 19, noted learning new information in the focus groups, like the fact colorectal cancer could result in reliance on a colostomy bag. Vomiting blood as a symptom of stomach cancer was unknown to most participants. Young people also reported learning that smoking can result in erectile dysfunction.

The health warnings that people found least effective had broader messages, like “Smoked to death” and “Thought you would only try it once?”

But some of these warnings didn’t match their picture, and that didn’t jive with participants. For instance, in the text warning “Smoked to death,” the picture was of a person who’s alive.

Participants said images considered unrealistic, like a gangrenous foot, were less credible because they didn’t believe it could be caused by smoking alone. While most were aware that cigarettes damage blood vessels, many did not know that loss of circulation can cause gangrene. And some young participants said they did not know what gangrene is.

This wouldn’t be the first time Health Canada had put real people suffering from a tobacco-related illness on a cigarette pack. In 2004 Barb Tarbox, a well known anti-smoking activist who died of cancer at 42, was featured on packages.

Health Canada says messages depicting people with compelling stories about the impact of smoking are effective in reaching smokers.

The current health-related labels for tobacco products contain three health warning testimonials from ill people, and Health Canada is seeking additional testimonials to be included in the new health-related labels.

David Hammond, a professor in the school of public health at the University of Waterloo, described cigarette packages as “little travelling billboards” circulating in several million pockets across the country.

“Smokers don’t really like the cute, rhyming taglines and I think part of it is they recognize this isn’t a jingle for a product you buy from the store,” he said. “This is a serious issue about their health and that’s why they tend to gravitate toward the straightforward, less jingly type of information.”

Tobacco companies have brought legal challenges against many countries, including Canada, over health warnings in an attempt to argue they’re “anti-smoker,” said Hammond, who’s been hired by the Canadian government to appear as an expert witness in a court case about packaging slogans.

Hammond said it’s a positive sign that diseases less associated with smoking, like colorectal cancer, might show up on packs.

“I think different warnings will connect to different groups.”

Janice Dickson, The Canadian Press

Like us on Facebook and follow us on Twitter.

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

A heavy police presence was on scene on Dec. 28, 2017 following the shooting death on Bates Road in Abbotsford of Alexander Blanarou, 24, of Surrey. (Abbotsford News file photo)
Three men charged with Abbotsford shooting death of Surrey man

Alexander Blanarou, 24, was killed in a rural area on Dec. 28, 2017

Photo by Dale Klippenstein
Hit-and-run driver knocks pedestrian into ditch in Abbotsford

Woman was walking in area of Harris Road and Riverside Street on Monday

Tabor Home in Abbotsford. (Ben Lypka/Abbotsford News)
B.C.’s largest COVID-19 care-home outbreak records 19 deaths, 147 cases

Tabor Home in Abbotsford has been battling outbreak since Nov. 4

Abbotsford residents gather in the Clearbrook area on Monday to demonstrate against what they say is unfairt treatment by the Indian government to farmers in the Punjab region of that country. (Maan Sidhu photo)
Abbotsford residents gather to protest unfair treatment of India farmers

Locals believe new bills will devastate small farms, demand farmers be allowed to protest peacefully

Menno Place. (Google Street View image.)
32 family members respond to Abbotsford care home’s plea for staffing help during COVID-19 outbreak

Menno Home asks for relief workers for food service, laundry and housekeeping

A tongue-in-cheek message about wearing a face mask to curb the spread of COVID-19 on a sign outside a church near Royal Columbia Hospital, in New Westminster, B.C., on Sunday, Nov. 29, 2020. THE CANADIAN PRESS/Darryl Dyck
B.C.’s COVID-19 infection count climbs back up to 656

20 more people in hospital, active cases still rising

Mirandy Tracy, left, and Tara Kurtz are two Langley mothers who are organizing a "sick out" for Tuesday, Dec. 1 to protest COVID conditions in schools. They're calling for masks and smaller class sizes, among other things. (Matthew Claxton/Langley Advance Times)
Politician, labour leader throw support behind student Sick Out day

Langley parents started the movement to keep kids home on Dec. 1 as a protest

A family emerged with a purchase at the Tannenbaum Tree Farm at 5398 252 St in Aldergrove on Sunday, Nov. 29, 2020 (Dan Ferguson/Langley Advance Times)
Christmas tree season is off to an early start

People are ‘bored’ with staying home due to COVID-19 and want to decorate early, farm owner believes

THE CANADIAN PRESS/Nathan Denette
B.C. researchers launch study to test kids, young adults for COVID-19 antibodies

Kids and youth can often be asymptomatic carriers of the novel coronavirus

Cannabis bought in British Columbia (Ashley Wadhwani/Black Press Media)
Is it time to start thinking about greener ways to package cannabis?

Packaging suppliers are still figuring eco-friendly and affordable packaging options that fit the mandates of Cannabis Regulations

A convoy of seven pickup trucks, six of which were hauling boats, makes its way around the Chilliwack Law Courts on Dec. 1, 2020. (Jenna Hauck/ Chilliwack Progress)
First court date for Fraser River anglers ticketed during demonstration fishery

Convoy of trucks circled the courthouse in downtown Chilliwack Tuesday honking their support

A sign is seen this past summer outside the Yunesit’in Government office west of Williams Lake reminding visitors and members to stay safe amid the COVID-19 pandemic. (Rebecca Dyok photo)
B.C. First Nation leaders await privacy commissioner decision on COVID-19 information

Release of life-saving data cannot wait, says coalition of First Nations

Most Read