Using prominent, graphic pictures on cigarette packs warning against smoking could prevent more than 652,000 deaths over the next 50 years, a new US study has found.
Such images may also prevent up to 92,000 low birth weight infants, up to 145,000 preterm births and about 1,000 cases of sudden infant deaths in the US, according to researchers from Georgetown Lombardi Comprehensive Cancer Centre.
The study is the first to estimate the effects of pictorial warnings on cigarette packs on the health of both adults and infants in the US.
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Although more than 70 nations have adopted or are considering adopting the World Health Organisation's Framework Convention for Tobacco Control to use such front and back of-the-pack pictorial warnings they have not been implemented in the US.
Pictorial warnings have been required by law, but an industry lawsuit stalled implementation of this requirement. Currently, a text-only warning appears on the side of cigarette packs in the US.
The study used a tobacco control policy model, SimSmoke, which looks at the effects of past smoking policies as well as future policies.
In the study, researchers including those at University of Waterloo in Canada and the University of South Carolina in the US, looked at changes in smoking rates in Australia, Canada and the UK, which have already implement prominent pictorial warning labels (PWLs).
For example, eight years after PWLs were implemented in Canada, there was an estimated 12-20 per cent relative reduction in smoking prevalence.
After PWLs began to be used in Australia in 2006, adult smoking prevalence fell from 21.3 per cent in 2007 to 19 per cent in 2008. After implementation in the UK in 2008, smoking prevalence fell 10 per cent in the following year.
The researchers used these and other studies and, employing the SimSmoke model, estimated that implementing PWLs in the US would directly reduce smoking prevalence in relative terms by 5 per cent in the near term, increasing to 10 per cent over the long-term.
If implemented in 2016, PWLs are estimated to reduce the number of smoking attributable deaths (heart disease, lung cancer and COPD) by an estimated 652,800 by 2065 and to prevent more than 46,600 cases of low-birth weights, 73,600 cases of preterm birth, and 1,000 SIDS deaths.
"The bottom line is that requiring large pictorial warnings would help protect the public health of people in the US," said Levy.
"There is a direct association between these warnings and increased smoking cessation and reduced smoking initiation and prevalence. That would lead to significant reduction of death and morbidity, as well as medical cost," he said.
The study was published in the journal Tobacco Control.
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