US makes new push for graphic warning labels on cigarettes

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This image provided by the U.S. Food and Drug Administration on Thursday, Aug. 15, 2019 shows proposed cigarette warning labels. (AP)
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Images show two of nine cigarette warning labels from the US Food and Drug Administration. (AP)
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This undated image provided by the U.S. Food and Drug Administration shows proposed graphic warnings that would appear on cigarettes. (AP)
Updated 16 August 2019

US makes new push for graphic warning labels on cigarettes

  • Canada became the first country to put graphic warnings on cigarettes in 2000

WASHINGTON: US health officials are making a new attempt at adding graphic images to cigarette packets to discourage Americans from lighting up. If successful, it would be the first change to US cigarette warnings in 35 years.
The Food and Drug Administration on Thursday proposed 13 new warnings that would appear on all cigarettes, including images of cancerous neck tumors, diseased lungs and feet with amputated toes.
Other color illustrations would warn smokers that cigarettes can cause heart disease, impotence and diabetes. The labels would take up half of the front of cigarette packages and include text warnings, such as “Smoking causes head and neck cancer.” The labels would also appear on tobacco advertisements.
The current smaller text warnings on the side of US cigarette packs have not been updated since 1984. They warn that smoking can cause lung cancer, heart disease and other illnesses. These warnings “go unnoticed” and are effectively “invisible,” the FDA said in its announcement.
The FDA’s previous attempt was defeated in court in 2012 on free speech grounds. A panel of judges later upheld the decision, siding with tobacco companies that the agency couldn’t force cigarettes to carry grisly images, including cadavers, diseased lungs and cancerous mouth sores.
FDA’s tobacco director Mitch Zeller said the new effort is supported by research documenting how the warnings will educate the public about lesser-known smoking harms, such as bladder cancer.
“While the public generally understands that cigarette smoking is dangerous, there are significant gaps in their understanding of all of the diseases and conditions associated with smoking,” said Zeller. If the agency is sued, he added, “we strongly believe this will hold up under any legal challenges.”
Reynolds American, maker of Camel and Newport cigarettes, said it supports public awareness efforts on tobacco, “but the manner in which those messages are delivered to the public cannot run afoul of the First Amendment.” Reynolds was one of five tobacco companies that challenged the FDA’s original warning labels.
The nation’s largest tobacco company, Altria, said it will “carefully review the proposed rule.” The company, which makes Marlboro cigarettes, was not part of the industry lawsuit.
Nearly 120 countries around the world have adopted the larger, graphic warning labels. Studies from those countries suggest the image-based labels are more effective than text warnings at publicizing smoking risks and encouraging smokers to quit.
Current US cigarette labels don’t reflect the enormous toll of smoking, said Geoff Fong, who heads the International Tobacco Control Project.
“This is a deadly product,” said Fong, who studies anti-tobacco policies at Canada’s University of Waterloo. “We have more prominent warnings on many other products that don’t pose even a fraction of the risk that cigarettes do.”
Canada became the first country to put graphic warnings on cigarettes in 2000.
Smoking causes more than 480,000 deaths each year in the U.S, even though smoking rates have been declining for decades. Approximately 14% of US adults smoke, according to government figures. That’s down from the more than 40% of adults who smoked in the mid-1960s.
Under the 2009 law that first gave the FDA oversight of the tobacco industry, Congress ordered the agency to develop graphic warning labels that would cover the top half of cigarette packs. The FDA proposed nine graphic labels, including images of rotting teeth and a smoker wearing an oxygen mask.
But a three-judge panel ruled that the FDA’s plan violated companies’ right to free speech. The judges said the images were problematic because they were “crafted to evoke a strong emotional response,” rather than to educate or warn consumers.
The FDA said it would develop a new batch of labels, but when new ones didn’t appear, eight health groups sued the agency in 2016 for the “unreasonable delay.”
Under a court order earlier this year, the FDA was required to propose new labels by August, with final versions by next March.


 


High on ease, low on nutrition: instant-noodle diet harms Asian kids

Updated 15 October 2019

High on ease, low on nutrition: instant-noodle diet harms Asian kids

  • In the Philippines, Indonesia and Malaysia, an average of 40 percent of children aged five and below are malnourished
  • Indonesia is the world’s second-biggest consumer of instant noodles, behind China

MANILA: A diet heavy on cheap, modern food like instant noodles that fills bellies but lacks key nutrients has left millions of children unhealthily thin or overweight in southeast Asia, experts say.
The Philippines, Indonesia and Malaysia have booming economies and rising standards of living, yet many working parents do not have the time, money or awareness to steer clear of food hurting their kids.
In those three nations, an average of 40 percent of children aged five and below are malnourished, higher than the global average of one-in-three, according to a report out Tuesday from UNICEF, the UN children’s agency.
“Parents believe that filling their children’s stomach is the most important thing. They don’t really think about an adequate intake of protein, calcium or fiber,” Hasbullah Thabrany, a public health expert in Indonesia, said.
UNICEF said the harm done to children is both a symptom of past deprivation and a predictor of future poverty, while iron deficiency impairs a child’s ability to learn and raises a woman’s risk of death during or shortly after childbirth.
To give some sense of scale to the problem, Indonesia had 24.4 million children under five last year, while the Philippines had 11 million and Malaysia 2.6 million, UNICEF data show.
Mueni Mutunga, UNICEF Asia nutrition specialist, traced the trend back to families ditching traditional diets for affordable, accessible and easy-to-prepare “modern” meals.
“Noodles are easy. Noodles are cheap. Noodles are quick and an easy substitute for what should have been a balanced diet,” she said.
The noodles, which cost as little as 23 US cents a packet in Manila, are low on essential nutrients and micronutrients like iron and are also protein-deficient while having high fat and salt content, Mutunga added.
Indonesia was the world’s second-biggest consumer of instant noodles, behind China, with 12.5 billion servings in 2018, according to the World Instant Noodles Association.
The figure is more than the total consumed by India and Japan put together.
Nutrient-rich fruits, vegetables, eggs, dairy, fish and meat are disappearing from diets as the rural population moves to the cities in search of jobs, the UNICEF report said.
Though the Philippines, Indonesia and Malaysia are all considered middle-income countries by World Bank measures, tens of millions of their people struggle to make enough money to live.
“Poverty is the key issue,” said T. Jayabalan, a public health expert in Malaysia, adding that households where both parents work need quickly made meals.
Low-income households in Malaysia depend largely on ready-made noodles, sweet potatoes and soya-based products as their major meals, he said.
Sugar-rich biscuits, beverages and fast food also pose problems in these countries, according to experts.
Rolling back the influence instant noodles have on the daily lives, and health, of people in southeast Asia will likely require government intervention, they said.
“Promotion and advertising is extremely aggressive,” said Thabrany, the Indonesian public health expert.
“There is massive distribution. They (instant noodles) are available everywhere, even in the most remote places.”