"We failed again, but you can trust us this time"

This study about graphic warnings has been getting a fair bit of coverage today, including from BBC online and The Scotsman. From the latter...

Teenage smokers ignore cigarette warnings

 
Picture and text warnings on the back of cigarette packets depicting the dangers of smoking have little impact on teenage smokers, a Scottish study suggests.

Researchers at Stirling University found that the graphic images and words were particularly ineffective in targeting teenagers who are regular smokers.

... Half the respondents in both surveys said they had “often” or “very often” noticed the warnings, and around one in five had very often read or looked closely at them.

But the percentage of regular smokers who noticed them fell from 77 per cent in 2008 to 66 per cent in 2011.

The graphic warnings were introduced in 2008, so a drop in the number of smokers who noticed them does not exactly constitute a roaring success.

Sterling University's Centre for Tobacco Control Research—for it was they who did the study—damned graphic warnings with the faintest of praise...

"Positioning pictorial warnings only on the back of packs may have had a deterrent effect on never and experimental smokers, but for most measures no significant differences were observed.

The impact on regular smokers was negligible."

The study is co-authored by our old friend Gerard Hastings, but even he was not able to polish this turd of a result. It's published in Tobacco Control so there are some attempts to portray the results in a positive light, but it's an uphill struggle and in the end, the authors don't really bother. Instead, they hope that the miserable failure of their last bright idea will encourage politicians to adopt their next bright idea—plain packaging. It's the usual story that is especially familiar to the people of Ireland— ie. "that didn't work so let's do more of it".

Graphic warnings are old news. We've had them in Britain for several years. No one seems to be particularly interested in whether they worked or not. The anti-smoking lobby has long since moved on to display bans and vending machine bans and the plain packs nonsense.

But we should be interested. It's not that long ago since graphic warnings were being pushed with the same fervour as plain packs are today.

Back in 2008, Deborah Arnott was pitching them as 'evidence-based' weapons against smoking...

Deborah Arnott, director of anti-smoking campaign group Ash, added: "The introduction of picture warnings on tobacco products is a strong visual reminder of the horrendous illnesses caused by smoking and the evidence is that they work."

All the other usual suspects were giving it large, such as Jean King from CRUK...

Jean King, director of tobacco control at Cancer Research UK, said: "The evidence-from Canada, Brazil and elsewhere-is clear.

"Graphic picture warnings inform people of the risks of smoking and help encourage people to reduce their smoking or quit altogether."

"They also help minimise uptake by young people."

And the BMA...

The British Medical Association said: "Placing graphic images on cigarettes packaging showing the horrible ways in which smoking can damage your health will undoubtedly encourage some people to give up smoking"

Except they didn't. As so often in tobacco control, the campaigners conflated "evidence" with "things we keep saying over and over again".

A comprehensive study from Canada, the first country to introduce pictorial warnings, found that “the warnings have not had a discernible impact on smoking prevalence.” A similar study in Britain found that those who saw the warnings said that it put them off smoking, and some smokers said that it made them think about quitting, but when it came to actually increasing the quit rate, the warnings made no difference (does this sound familiar?). As the researchers noted: “With the exception of an increase in avoiding the messages, there were few behavioural changes post implementation of the pictures.” They continued:

There were few changes post implementation of the picture health warnings in the number of health effects recalled or participant’s perception of risk... There were no differences post implementation of the picture health warnings in the number of smokers reporting forgoing a cigarette when about to smoke one or stubbing out a cigarette because they thought about the health risks of smoking... Among young people, the impact of picture health warnings was negligible.

Graphic warnings were a damp squib, as this latest study from Hastings et al. confirms. The gulf between what anti-smoking campaigners promise and what actually happens when governments capitulate to their demands deserves more attention than it receives. It is worth bearing their track record in mind next time you hear them wittering on about "overwhelming evidence" and how policy X is going to deter young people from taking up smoking.