The federal health strategy that attempts to limit tobacco use has taken an odd, but perhaps understandable turn. The Department of Health and Human Services wants to require cigarette packs to devote about half of their surface area to images designed to dissuade people from using the product, though dissuade is too mild a word — disgust, shock or frighten might be more accurate. The images include healthy lungs beside diseased, cancerous lungs, a late-stage cancer patient’s face, the tracheotomy hole in a neck through which a patient still inserts a cigarette, and gravestones.
It is time to consider what options remain this side of making tobacco illegal.
This latest tobacco prevention strategy aims for “bold and historic action that will improve health, save lives and save health care costs for employers, workers and taxpayers across the country,” according to a statement in support of the new strategy by the Campaign for Tobacco-Free Kids. The stakes are certainly high for those working to block preteens and teens from starting to smoke. The costs in lives and public and private dollars are way too high for policymakers to be complacent, especially given recent resurgence in the numbers of young adults who are using tobacco.
And it is the young who must be stopped from smoking. Nearly 20 percent of high school students smoke. Very few begin smoking in their 20s. But young people also are hard to disgust, shock or frighten. In fact, decades ago, subliminal advertising often relied on hidden images that suggested danger and death that targeted the subconscious minds of the young. The idea was that taking up cigarettes or alcohol was as death-defyingly cool as driving a sports car at 100 mph.
So when the images of gravestones fade into the background, what’s next? Using an audio chip, such as those featured on funny greeting cards, which shout warnings of horrible death? The last option, it would seem, is to make tobacco illegal. Tobacco companies could be given 10 years to phase out production, and laws passed to ban the sale of tobacco. But we’ve been down the prohibition road before, and it is not a pleasant ride.
A step just short of prohibition is to drop federal subsidies for tobacco farmers and to impose taxes on the producers of cigarettes. That would raise the price further, putting the product out of reach of many teens and preteens.
Another drastic step would be to have smokers pay a steep premium for health insurance. An ancillary to this approach has been seen in employment practices, with some businesses and organizations refusing to hire those who smoke. So far, such practices have not been found unconstitutional.
There is a better way. It’s not a silver bullet, but the most effective strategy is education. Unfortunately, educating preteens about the dead end of tobacco use is a job that is never completed. It is a job with steady failure rate, as inevitably some percentage will continue to try tobacco. And if shocking images on cigarette packages are part of the plan, there is little downside.