1. Who Should Decide What’s Safe? Mallory Cases, MPH, CPH Hypothetical Course: Health Meets Life

2. Course Objectives Explain how policy and law affect population health. Understand the role of prevention in promoting a healthy community.

3. Some background knowledge… Some tobacco companies are working to develop a cigarette they say will be safer than products currently on the market But who decides what's safe?

4. Some history… Enacted in 1965, landmark federal legislation required health warnings on cigarette packages In 1984, the law was amended to require one of the four warning labels below in most cigarette-related advertising

5. Activity Read the federal laws regarding cigarette package labeling and advertisements and then decide what role you think the government should play in public health concerns Form groups for teaching demonstration activity Each group pick up 1 set of handouts

6. U.S. Code Title 15—Commerce and Trade; Chapter 36—Cigarette Labeling and Advertising; Sec. 1333. Labeling; requirements; conspicuous statement Required warnings; packages; advertisements It shall be unlawful for any person to manufacture, package, or import for sale or distribution within the United States any cigarettes the package of which fails to bear, in accordance with the requirements of this section, one of the following labels: (see below) It shall be unlawful for any manufacturer or importer of cigarettes to advertise or cause to be advertised (other than through the use of outdoor billboards) within the United States any cigarette unless the advertising bears, in accordance with the requirements of this section, one of the following labels:

7. Question 1 What impact do you think these warnings have had on the smoking population? Defend your reasoning.

8. Question 2 Evaluate each warning. What message does each warning convey?

9. Question 3 Would different language create more of an effect? If so, what?

10. Question 4 Is it enough to warn consumers that a product is dangerous or should its availability be controlled? Explain your answer.

11. Do they have an effect? Warning labels have been found to inform smokers about the health hazards of smoking, encourage smokers to quit, and prevent nonsmokers from starting to smoke. Warning labels on tobacco products are an ideal way of communicating with smokers. Since the intervention is delivered at the time of smoking, nearly all smokers are exposed to warning labels and pack-a-day smokers could be exposed to the warnings more than 7,000 times per year. Further, two-thirds of all smokers indicate that the package is an important source of health information and health knowledge is strongly associated with an intention to quit smoking.

12. References http://www.pbs.org/wgbh/nova/education/activities/2810_cigarett_01.html https://www.tobaccofreekids.org/research/factsheets/pdf/0325.pdf Hammond, D, et al., “Impact of the graphic Canadian warning labels on adult smoking behavior,” Tobacco Control 12(4): 391-395, December 2003. Hammond, D, et al., “Effectiveness of Cigarette Warning Labels in informing smokers about the risks of smoking: Findings from the International Control Four Country Study,” Tobacco Control 15(Suppl III):19-25, June 2006.