THE SURGEON GENERAL’S declaration that cigarette smoking was “hazardous” first appeared on the sides of packs in 1966, a year or so before I lit my first coffin nail, circa age thirteen. Did it stop me? Hardly. Four years later, the warning was escalated to “dangerous,” not that many people noticed or cared. In 1985, carton sides began to feature a whole array of cautionary messages: warnings about lung cancer, emphysema, low birth weight, carbon monoxide, and so on. By that time it was getting harder to find movie theaters in which you could smoke, but otherwise the landscape was unaltered. Nearly everyone I knew still smoked.
In the past decade or so, beginning in Canada and gradually spreading around the globe, warning images appeared to accompany the verbal admonishments, which were now printed in large type on the front of packs. In many countries, the warning was required to cover as much as 50 percent of the front of a pack and sometimes the entirety of the rear. The United States, home of “free choice,” lagged behind until just recently, when the Food and Drug Administration, now given the authority to regulate tobacco products, issued a ruling, to take effect in June, that will compel tobacco companies to cover the top halves of the fronts and backs of all cigarette packs with antismoking images.
At this writing there are thirty-six proposed images, meant to be pared down to nine. The most bracing of these shows a smoker exhaling through a hole in his neck, the result of a tracheotomy. The rest of them mostly tend toward the synecdochic: toe tags, coffins, X-rays, breathing equipment, unhappy children engulfed in smoke. There are also time-tested propaganda images (a figure dangles from a puppeteer’s strings), oblique calls to sentiment and duty (a warning in a child’s handwriting on double-ruled paper), and representations of positive reinforcement (a beefy everyman exposes his I QUIT T-shirt slogan, a pretty woman blows a bubble).
In Europe the imagery is more blunt—diseased lungs, rotting teeth, open-heart surgery, and an evil-looking bloody growth protruding from someone’s neck. The pictures are effective, although Belgium, Romania, and the UK are thus far the only countries to actually employ them. As an occasional recidivist who has been known to purchase the odd pack of smokes while abroad, I can attest to the fact that finding one of the more gruesome images on the box slid across the counter by the tobacconist is a disquieting experience, and may result in the pack getting tossed before it has been emptied. A more common solution, however, is to drop the pack into a slipcase—they are readily available in cardboard or plastic. (I have one that bears Che Guevara’s face, for no particular reason.)
But then, in ascending order of grimness, there are the package designs mandated by Australia (gangrene, for example, and very literal clogged arteries), the Philippines (giant goiter, among other things), Brazil (surrealistic montages, including a representation of a stroke that looks like an ax has been driven into the brain and a warning of wrinkled skin that makes the model appear to have been mummified centuries ago), and a trio of Asian countries that might as well be competing for most unendurable imagery: Malaysia, Singapore, and Thailand. All three of them cover their packs with medical-atrocity photographs, and all three, interestingly, are neighbors of Indonesia, one of the biggest cigarette markets in the world and the largest country to have spurned all attempts at reform. But the winner of the sweepstakes is Iran, which goes the extra inch. Iran’s photographs barely even appear medical—they look like police photos of carnage. Even a glimpse of an Iranian cigarette pack should be enough to make anyone go cold turkey on the spot. Photos like these are perennially fresh; we are never prepared for them, unlike images of violence, which are blunted in our minds by centuries of stylized antecedents.
It seems curious, then, that Dr. Lawrence R. Deyton, director of the FDA’s Center for Tobacco Products, was quoted by the New York Times as saying that “sometimes images that are not as graphic may be more powerful in terms of changing behaviors.” But it is possible that Deyton possesses greater insight than I do. Maybe Iranian smokers laugh at pictures of half-eaten faces in shades of gore, bile, and pus. Or maybe it is that America, alone among nations, responds more readily to the symbolic than the graphic. Perhaps the consumer base will find the image of a well-groomed spokesmodel apparently asleep in a satin-lined casket to be bottomlessly tragic and compelling. Maybe they will be more deeply affected by a staged photo of a sixtyish businessman clutching his heart than by a picture of the diseased organ itself, looking like week-old unrefrigerated meat. But then again, it may just be that the committee in charge of designs achieved a familiar compromise: The consumer should be shocked but not alienated. That, after all, would be bad for business.
Luc Sante’s most recent book is Folk Photography: The American Real-Photo Postcard 1905–1930 (Verse Chorus Press, 2009).