Free Speech – Will risking it really help smokers quit?

The Boston Globe reported last Wednesday that a federal judge blocked the new FDA requirement that tobacco companies put graphic images on cigarette packaging. The article outlined the judge's ruling that requiring the images, which include "a sewn-up corpse of a smoker and a picture of diseased lungs, on cigarette packs violates the free speech amendment to the Constitution.”

This raises a serious issue, presenting all, including educators, with a dilemma. On the one hand, evidence that smoking kills is overwhelming. I had to watch it destroy my mother’s favorite uncle. Efforts to help smokers stop and aid teenagers to avoid smoking are commendable. Clearly, we’d all be better off if smokers quit in droves.

Reducing smoking-related illnesses is a worthy goal. But is it worth eroding the cherished freedom of speech on which all Americans, especially educators, depend? That’s a question for the Supreme Court. Despite the health issues, the specter of government edicts forcing organizations to publicly say negative things about their activities is not a pleasant one. So, we must ask – is the reward worth the risk? Do graphic, fear-arousing images actually help people quit smoking?

What the research shows

There is no question that graphic images on Canadian and Australian cigarette packs have proven to make smokers think about health hazards and consider quitting. A WHO bulletin stated, “The research on pictorial warnings show that they are: (i) more likely to be noticed than text-only warning labels; (ii) more effective for educating smokers…and for increasing smokers’ thoughts about the health risks; and (iii) associated with increased motivation to quit smoking.”

But motivation doesn’t necessarily translate into action. Consider how noted social psychologist and textbook author Dr. David Myers summed up the research: “Many people who have been made to fear an early death from smoking continue to smoke. When the fear pertains to a pleasurable activity, notes Elliot Aronson (1997), the result is often not behavioral change but denial.”

In fact, the eminent Dr. Aronson states that studies show smokers who’ve tried to stop and failed are the group most likely to deny or minimize the hazards of smoking. They rationalize it away. Aronson and his coauthors cite research showing ways that frightening pictures can actually reduce smoking. Smokers shown graphic images of lung cancer and then given a pamphlet outlining ways to quit lowered their daily cigarettes by 77% (from 69 to 26). Those who saw disturbing photos without specific instructions smoked less for a time, but soon returned to smoking nearly as much as they had before (64 daily cigarettes merely dropped to 54).

But even the group who substantially reduced their cigarette intake continued to smoke during the three month study. I could locate no data showing that graphic images on cigarette packaging really helps people quit. In fact, a Prevention First report states that fear tactics are ineffective in deterring young people from smoking. Is it worth eroding freedom of speech for a smoking cessation strategy not proven to help substantial numbers to stop?

An alternative

Influence expert Robert Cialdini, PhD told me in personal correspondence that one way to reduce negative behavior is to link it to a disliked or disrespected outgroup. Nicotine is a highly addictive drug. Perhaps we need ads comparing tobacco companies to drug cartels and cigarette dealers to those who sell dangerous drugs in neighborhoods and schools. That exercise of free speech might get results!

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