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Surgeon General's Warnings


"A KOOL penguin you say?" the old man said and pausing, turned. His face, revealing a lonely haunted look that spoke of a deep sadness and emptiness. Then, with the remorse of a man once very much in love, he continued, "You know KOOL cigarettes, they killed my wife. She smoked them . I tried so hard to help her stop, but she couldn't." .....

Secondhand Store Owner, Connecticut.
(Repeated here because it needs to be told more than once.)

Preamble

  Could it be that during their youth, smokers learn to practise evasion of the truth and develop a kind of selective hearing? Highlighting what they consider important and dismissing that which for some reason they consider unimportant? A committed smoker does not want to hear any bad news concerning cigarette smoking from any source - in by-gone times the king would hang the bearer of bad tidings - and thus will shield themselves from realising the full truth concerning it.

Facing the truth of a one in three (1 in 3) chance of dying from lung cancer or the truth of a one hundred percent (100%) chance of severe and permanent lung impairment, takes a lot of conscious evading and rationalizing.

  As a consequence good advice from the government, elders and peers alike goes unheeded or deliberately forgotten. (A sad fact that the tobacco companies are all too aware of, and probably use in some way to their pecuniary advantage). Thus every time a smoker lights up he or she does so in the face of mounting evidence that it is a suicidal act. Did you know that nicotine promotes the growth of blood vessels that can feed the cancers caused by the toxic part of the tobacco smoke?

  Every time a smoker lights up he or she does so in defiance of a government mandated warning printed right there on the pack. Currently one of four warnings that the smoker has probably never read, studied or researched. (And even if read some are so cryptic that it is possible that many smokers could not clearly discern the point being made).

  In this page a peek will be taken at these warning labels, explore some novel ways to get inside them and expose their mysteries...

Preface

 Nowadays, if the government suspects some medicine as a cause of death (q.v Fen-Fen) it is immediately withdrawn from the market. If some pesticide or other chemical is demonstrated to be even remotely harmful to health it is withdrawn from common use to prevent it from entering the environment and to prevent the uninitiated from getting their hands on it, those who might accidentally or otherwise use it to cause harm. The Government neither wants to see damage done or be negligent in this regard.
  Where cigarettes are concerned, if R.J.Reynolds or Philip Morris were to invent them today then the F.D.A would be forced to regulate them out of existance. However they are a world wide custom of the human race and matters are far more complex. It will take a long time, if ever, for governments to get rid of cigarettes, the voters smoke them, the government taxes them, the tobacco companies give campaign contributions and have a powerful lobby. Getting a simple warning label placed on a cigarette pack, was the first step in a lengthy process.


Murad Ad Dancers

  That great man, Gallileo proved that the planets rotate around the sun, he also discovered to his great cost and to the everlasting shame of the church that politics can take a long, long time to catch up with science.  The Surgeon General is arguing, in the way of Gallileo, that smokers quickly become addicted to the nicotine in cigarettes: Which is equivalent to the smoker (Planet Earth) rotating around the cigarette addiction (sun).  The tobacco companies are arguing, in the way of the 17th century church, that the smoker is in the center and choses to smoke or not smoke at will. Thus the cigarettes rotate around the smoker.   Anyone who has tried to stop smoking knows that it is not a simple matter of chosing to stop, for the moment the attempt is made the truth of addiction immediately becomes apparent


Before There Were Any Warning Labels

Lucky Strike M.D.

The American Tobacco Company's early version of a of a warning label.

(We don't know who he was but he is clearly very much in love with the product. They should never have allowed him to stand in for the Surgeon of General and 20,678 other M.D.s.)

Even though the tobacco companies knew about the hazards of smoking back in the 1930's, they cleverly used M.D.s and implicitly the idea of health to promote the product. There was increasing public awareness concerning the health problems associated with cigarette smoking. This, they percieved, if left unchecked would threaten their corporate bottom line, especially since the business was just beginning to take off in a big way. Countless billions of dollars in potential profits were at stake. Health risks could take second place, never in all history had such a money making machine been created, and thus the conspiracy was born... The conspiracy of the tobacco companies to systematically withold what they knew about the dangers of cigarettes from their customers.



The First Attempt At a Warning Label

'CAUTION: CIGARETTE SMOKING MAY BE HARMFUL TO YOUR HEALTH.'


Doctor Kool

Only then, some thirty years later in 1964 the then Surgeon General, Luther Terry, courageously issued his landmark report on "Smoking and Health". It for the first time "officially" implicated tobacco smoking as a veritable Pandora's Box.
Something urgently had to be done, but what? The solution was warning labels and an upsurge of activism on behalf of public health. At the end of the decade, after much wrangling with the Tobacco companies the first warnings appeared on packs of cigarettes. It stated the following:

'CAUTION: CIGARETTE SMOKING MAY BE HARMFUL TO YOUR HEALTH.'

Any warning is probably better than nothing. But this as a warning seems very mild, and possibly ineffective, it says very little.   The warning could be at the side of a swimming pool or a ladder:

CAUTION: LOW RISK OF DROWNING.

or

CAUTION: BE CAREFUL NOW, YOU MIGHT FALL OFF AND HURT YOURSELF.



To get a better feel for the uselessness of this label, try writing it out, like this:...


CAUTION:
Cigarette smoking may be,
Cigarette smoking may be
Harmful to your health.
Cigarette smoking may be

Then sing it to the tune of "Happy Birthday to You". Or if you feel creative make up your own little song.

  This is what the Surgeon General would probably have required it to say:

F.D.A. WARNING: Don't Smoke These. They produce several highly toxic gases. If you persist, you will become heavily addicted. They will most certainly Kill You. No 'Ifs' or 'Buts'. You will painfully die from one or several of the following causes: Lung, Mouth or Throat cancer, Emphysema, Gangrene, Stroke, Heart Attack and Other Incurable Diseases (The list keeps growing as more is discovered.) We also suspect that your secondhand smoke is killing your family. So Quit NOW!

  A statement of the facts as they were known in 1969, and do not lend themselves to being turned into a happy song. ( Try singing "Huffily, Puffily, gas your kids, with tobacco smoke... " to the tune of "Merrily Merrily Row Your Boat..." it palls...)

When the new label appeared the Surgeon General and the public health interest groups knew they had been cheated and immediately clamoured for a more effective label. And in 1972 a new label appeared, but such was the collective power of the tobacco companies, that all they got was another dose of delaying tactics, something a little more assertive but just as vague...


The Second Attempt at a Warning Label

'WARNING: THE SURGEON GENERAL HAS DETERMINED THAT CIGARETTE SMOKING IS DANGEROUS TO YOUR HEALTH.'

This warning label says very little, it just deals with some non-specific threat to health posed by the product, "Dangerous" does not of itself imply incurable or fatal. It even suggests that the smoker might be able to control the health outcome in some way.

The words 'Surgeon General' appear for the first time. It is doubtful if the Surgeon General had any final say in the wording of this warning.

Whoever wrote this is using the implied authority of the title to add weight to what is merely an announcement. Then by the strategic use of the word 'determined' it evokes doubt in this authority by making him appear to be inexpert or lesser. It is altogether an extremely clever piece of political doublespeak.

A real warning would be strident and say 'has fully demonstrated' or 'has proven beyond all shadow of doubt', then clarify the danger and urge the smoker to stop. All this pseudo warning achieves is to draw the attention of smokers to what they already know and deny.

On this occasion the office of the Surgeon General appears to have been poorly served by the tobacco companies.

1972 Camel Pack

The warning label was hidden away on the side of the pack, hard to find and read, where all 'warnings' languish to this day. It was also required to be exhibited on all advertising. And at first the tobacco companies coyly displayed it on the side of a picture of a cigarette pack. At that scale it was barely noticeable and did not detract from the overall look and feel of their advertisements. This ploy did not last long and the warning was required to be placed in the white box we are all so familiar with today.

To demonstrate the failings of this warning label, it could be turned into a poem.

WARNING:
The Surgeon General has determined,
(Using statistics on wealth).
That cigarette smoking is dangerous, (but
seldom worse
) to your Health.

This second label lasted until 1985 when mounting pressure from the anti-tobacco lobby in congress forced its retirement. It was replaced with the 4 rotating warning labels that have been in use up to this day.



The Third Attempt: A Set of Warning Labels

This time the government came up with the idea of a 'Puzzle'. They decided to place four fragments of the truth on the side of the packs. Then it would be up to the consumer to research the rest and put the picture together for themselves. It is the kind of "hands off" government we have always wanted. Sadly however not everyone out there has either a degree in medicine, or the time to do the fundamental research.

For the last few decades, in which science and public attitudes have not stood still, these 4 rotating puzzle warnings have been in effect:

  1. ' SURGEON GENERAL'S WARNING: Cigarette Smoke Contains Carbon Monoxide. '
  2. ' SURGEON GENERAL'S WARNING: Smoking Causes Lung Cancer, Heart Disease, Emphysema and May Complicate Pregnancy. '
  3. ' SURGEON GENERAL'S WARNING: Smoking By Pregnant Women May Result In Fetal Injury, Premature Birth and Low Birth Weight. '
  4. ' SURGEON GENERAL'S WARNING: Quitting Smoking Now Greatly Reduces Serious Risks to Your Health. '

  Upon taking a closer look at the labels the folowing becomes apparent:

  1. The Surgeon General has now been given full resposibility as the authority for the warnings, presumably this is supposed to make the smoker sit up and take notice. Although some very honourable people have held the position, the Office of the Surgeon General is unfortunately an honorary position, appointed by the President and has no authority to do anything, the job is advisory. An F.D.A. warning would mean a lot more and could have some teeth.
  2. They do not address addiction. This is unfortunate since normal methods of reasoning won't get through to a mind that is addicted and has a blind and unreasoned confidence in the product (mostly caused by the heavy influence of the tobacco companies ).
  3. They appear to be incomplete, and still deal in general terms.

Here is a resumé of some of the other saliencies and missing parts

  1. The labels are still virtually INVISIBLE, hidden on the side of the pack.
  2. The language of the warnings is not the language of warnings.
  3. They do not carry the weight of an enforcing authority.
  4. They do not Alert and promote FEAR.
  5. Everything else that is in the 'Smoke' besides Carbon Monoxide.
  6. No mention of NICOTINE.
  7. The packs do not contain a list of what is actually consumed.
  8. The language 'HIGHLY ADDICTIVE' is nowhere to be read.
  9. Not all the possible INCURABLE diseases are mentioned.
  10. The matters of IMPOTENCE and DISFIGUREMENT are omitted.
  11. The truth concerning pregnancy and smoking is not revealed.
  12. There is no mention of the threat of SECONDHAND smoke.
  13. It can be done. Countries like Australia have proper and correct labels that offer full and complete disclosure of all the known hazards.

So much for the missing vital information, but what do they actually say? The next segments will play with the puzzle and develop the theme.



Part One

Carbon monoxide warning

' SURGEON GENERAL'S WARNING: Cigarette Smoke Contains Carbon Monoxide. '

Buy a pack of cigarettes and it stays inert and harmless until used as directed. The directions - something usually learned at school as an extra-curricular activity - are as follows:

  1. Open up the pack.
  2. Extract a cigarette.
  3. Place cigarette, butt first, in mouth.
  4. Light a match.
  5. Ignite by placing lit match close to tobacco end and applying a rapid series of sucks.
  6. Inhale the smoke from lit cigarette, hold breath for approximately 3 to 7 seconds and then slowly exhale.
  7. Repeat step 5 and keep repeating until the cigarette is consumed as far down as the butt.
  8. Extinguish and discard the butt.
  9. Smoke as often as desired or allowed.
  10. Look cool whilst doing it.

  Its all about making smoke and sucking it into the lungs until the desired effect is achieved. Do this enough times and it will kill you.

So this first label in the puzzle warns that cigarette smoke contains carbon monoxide, and in offering no other ingredients for our consideration, implies that..

  • That is all there is to it.
  • Its the carbon monoxide in the tobacco smoke that is the one major player.
  • Carbon monoxide is responsible for the list of ailments itemized on the other three labels.
  • The reason for quitting is the carbon monoxide.
  • Carbon monoxide is the arch villain of smoking.
  • Get rid of the carbon monoxide and smoking will once again be just dandy!
  • Most people don't even know what carbon monoxide does.
  • Carbon monoxide binds with the blood preventing the smoker from getting enough oxygen unless the heart beats faster. Thus it puts a strain on the heart.

  Only listing the one ingredient is highly deceptive. Cigarette smoke contains at least 500 different chemical components that exist either as gases, particles or distillates. It is not yet known what harm all of them may do, but there are some notable players. Like Nicotine, Benzo(a)Pyrenes, Nitrosamines, Radioactive Polonium, Cyanide Gas, Ammonia... etc. Agents that will: stupify and destroy the lungs; promote cancers, strokes and heart attacks; and cause extreme addiction. A veritable witches brew of extremely unwholesome stuff, that any M.D. in his or her right mind would declare unfit to be put in anybody's lungs.

  This warning label is unfortunate by what it omits. It seems to be a mental sleight of hand, a smokescreen for the actual truth. There may however be some perfectly valid psychological reason for using this paricular design.

  Here is a suggested alternative warning based on what is actually in the smoke:-

FDA Poison Alert...

' F.D.A. POISON WARNING: Cigarette Smoke is Toxic and Lethal. It Contains; Addictive Nicotine, Potent Carcinogens, Necrotizing Gases, Tars, Poisons, Carbon Monoxide, Ammonia and Such... '

  The idea is to get the smoker to understand that he or she is swallowing, on a regular basis, the major ingredients of a sewer.



 Part Two

S.G.W: Smoking Causes Lung cancer...

' SURGEON GENERAL'S WARNING: Smoking Causes Lung Cancer, Heart Disease, Emphysema and May Complicate Pregnancy. '

What to make of this? It depends on the purpose of this warning. If it is to frighten people then the list of ills as published is frightening enough without adding any more and should be enough to warn off all but the most foolhardy smokers. However the labels have been in force for almost 20 years and have had only a small effect. Addiction appears to be much stronger than common sense. Then what would constitute a more effective warning of this kind?
  It may be useful to review what is missing from it:-

  • The list of diseases is incomplete
  • For example, it should read Lung Cancers as there are several different kinds.
  • It is deceptive in that it does not suggest that the list is incomplete.
  • It does not state that the diseases are nearly always fatal.
  • Missing are other cancers such as throat cancer, mouth cancer, stomach cancer and colon cancer.
  • Gangrene and Strokes don't even get a mention...
  • Chronic Bronchitis, Hacking Coughs, Arterial Hardening and other permanent disabilities, conveniently forgotten.
  • May Complicate Pregnancy? (This will be considered in the next label).

  And this list is only for starters, it is in itself not complete.

  The author is not a trained psychologist and there may be good reasons for these sparse warnings. However take a quick look at any other consumer product and as anyone can see, they are festooned with labels and lists of contents, warnings and advice; and for the main part these are all relatively safe products. Someone wants to make very sure that the consumer is fully informed. There is this difference with cigarettes where someone only wants the consumer to know part of the story. And again, there may well be a good reason for all this mystery.

  However it's worth pressing on with this exercise, and here, for what they are worth, are the authors suggestions...

  What might be even more useful is something immediate and to the point, an actual and real WARNING!

  A lighthouse is placed where its light can be seen and warn mariners not to get too close, else their ship will founder on the rocks and sink. A good lighthouse also has a loud fog-horn that cuts through any fog that might be obscuring the light. The warning here needs to advise the smoker that there is present an immediate danger and should alter course at once. The warning should perhaps shout... Don't proceed any further, Stop, Turn Round, Go Back and Get Help... As well as to-the-point language, it should also contain symbols and pictures as these can go direct to the subsonscious. (The official biohazard symbol would be very effective).

Here is a possible version aimed at younger smokers, it is still in need of further development.

FDA Extreme Hazard Alert...

' F.D.A. EXTREME HAZARD ALERT: Smoking Cigarettes Will Utterly Wreck Your Life. Snuff Them Out, Now! (Diseases Listed on Pack) Dial 1-800-FDA-#### for Help and Information. '

If a person is being warned they don't need to be made to wade through a list of half understood diseases. They need a severe warning, well written information and a telephone number, or a web address where help can be obtained.



Part Three

S.G.W: Smoking By Pregnant Women...

' SURGEON GENERAL'S WARNING: Smoking By Pregnant Women May Result In Fetal Injury, Premature Birth and Low Birth Weight. '

  The third piece of the puzzle simply elaborates on the vague part of the second warning where it mentions "And May Complicate Pregnancy". Most smokers have never read the warning labels are not aware that there are four of them, and consequently don't know what they say.

  This warning wants everything both ways - it says "May" and also takes the trouble to warn us. Either Cigarettes do or they don't - for instance jump from 30 feet, the jump may kill you or it might not; but it will certainly harm you.

  This warning seems willing to gamble on motherhood

  The term 'fetal injury' is not specific and needs to be researched before a decent alternative warning can be designed.

  But as this one better be rewritten and soon here is an interim version:

F.D.A. Damage Advisory...

' F.D.A. DAMAGE ADVISORY: Cigarette Smoke Destroys Children's Health. From Conception to Birth to Adolescence To Maturity. Responsible Mothers and Fathers Do Not Smoke Cigarettes. '

  It would be even better to add, neither before, during or after pregnancy. Especially after, since the secondhand smoke is extremely dangerous to the newly born and young children. Again a phone number and web address where further information can be obtained should be appended.


Part Four

S.G.W: Quitting Now...

' SURGEON GENERAL"S WARNING: Quitting Smoking Now Greatly Reduces Serious Risks to Your Health. '

  This another of those vague warnings "Serious Risks to Your Health". This is further follow on advice from label two. Presumably whoever wrote these warnings imagines they have supplied enough data to allow all smokers to form a complete and valid set of views, concerning the hazards of cigarette smoking. And consequently all smokers are now in a position to chose whether or not to smoke or to quit, just like that!
  Curiously the fact of addiction is nowhere figured into the design of these warnings. For if addiction is not considered as part of the design, then it surely must render any warning, ineffectual?

  One way to think about the problem of addiction, is to recall the childrens game - Rock, Scissors and Paper. Addiction is like 'Scissors' to a 'Paper' warning, it just cuts it up. A Warning to stop smoking needs to be able to halt the scissors, paper and rock of addiction, only something like a heavier rock, broader paper and powered titanium scissors will do -

  A warning that is heavy, factually direct and razor sharp.

  It will probably take many attempts to come up with an effective label to replace the current one. Here is a first stab at it:-

F.D.A. Shock memo...

' F.D.A. SHOCK MEMORANDUM: Do Get Rid of This Pack. Cigarette Smoking Addicts, Causes Impotence, Disfigures, And Is A Painful Suicide.'

Vanity Fair...Have you ever seen the face of someone who has had oral surgery? Throat surgery and no longer has a voice box? A person with emphysema carrying a portable oxygen device to help them breathe?

The results of this terrible epidemic are there to be seen.



Part Five - Conclusions.

There really is only the one label. It has been published in four parts in such a way that the reader never quite gets to put the full picture together. And even if it was put together, it reveals little and certainly does not seem to adequately get through to its target audience of addicted smokers. There may be excellent reasons for this, but the author is at a loss to know what these may be.

Behind all these "warning labels" the influence of the tobacco companies is clearly at work. They must be very pleased with them.
  These warnings satisfy their rebuttal policy, which is that smokers 'choose to smoke'. They have been very reluctant to allow any involvement from the F.D.A., which so far they have succeeded in blocking. They are also fully aware that choice has little to do with smoking...and know that smokers get addicted from the first few puffs...

  What is probably needed is something more than just four warning labels. But as an interim suggestion Collated here are the four alternate warning labels that the author would like to see employed.

' F.D.A. POISON WARNING: Cigarette Smoke is Toxic and Lethal. It Contains: Addictive Nicotine, Potent Carcinogens, Necrotizing Gases, Tars, Poisons, Carbon Monoxide, Ammonia and Such... '

' F.D.A. EXTREME HAZARD ALERT: Cigarette Smoking Will Utterly Wreck Your Life. Snuff Them Out, Now! (Diseases Listed on Pack) Dial 1-800-FDA-#### For Help and Information. '

' F.D.A. DAMAGE ADVISORY: Cigarette Smoke Destroys Children's Health. From Conception to Birth to Adolescence To Maturity. Responsible Mothers and Fathers Do Not Smoke Cigarettes. '

' F.D.A. SHOCK MEMORANDUM: Do Get Rid of This Pack. Cigarette Smoking Addicts, Causes Impotence, Disfigures and Is A Painful Suicide.'

  You are encouraged to figure out how best to inform and warn smokers of the many hazards that they are exposed to by continuing to smoke cigrettes...Try designing labels that incorporate personal reasons for getting rid of cigarettes.


Mamma's Darling
We also don't know who this fellow was but he probably never grew up to become the Surgeon General.

Let it Pass.

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