Author: Tegan Taylor
When it comes to the health risks associated with smoking, most people know about lung cancer and heart disease. But less than a third of Australians realise it can also cause conditions such as acute leukaemia and rheumatoid arthritis, according to a new study, raising the question around whether current graphic cigarette warning labels need to be refreshed.
The study, published in the Medical Journal of Australia, asked 1,800 Australians about whether they thought smoking increased the risk of 23 conditions shown to be associated with tobacco use, such as lung cancer, stroke and diabetes.
While more than eight in 10 participants knew lung, throat and mouth cancers, heart disease and emphysema were linked to smoking, much fewer were aware it was associated with erectile dysfunction, female infertility, diabetes and liver cancer.
The results showed the current warning labels were doing their job, and that it might be time to expand them, said Michelle Scollo from Cancer Council Victoria, which ran the study.
“It was predictable and pleasing that smokers knew about the health effects that have been highlighted in the current sets of warnings and media campaigns,” Dr Scollo said.
“[But] fewer than half realised it could reduce your fertility, and that could have a really major impact on the course of people’s lives … There’s a lot that people need to appreciate.
Part of the reason the link between smoking and some of the conditions surveyed aren’t well known is because research into the health effects of tobacco use has advanced since the time the current warnings were developed, Dr Scollo said.
The current set of graphic warning labels have been in place since 2012.
“In 2014, the US Surgeon-General released a 50-year report — they released a whole updated statement of the diseases caused by smoking. Many more conditions were added to the list in 2014,” she said.
“These health warnings came into effect in 2011-12 and a lot more things have been established. Liver cancer, colon cancer … diabetes, erectile dysfunction.”
Dr Scollo hoped the research would lead to an expanded campaign including new graphic warning labels, showing more of smoking’s health risks.
“People need continuous reminders of these sort of things if they’re going to remember them but I don’t see why we need to be limited to just 14 warnings,” she said.
“I think we need as many warnings as we need to adequately warn people about the risks they face.”
There is value in looking at people’s awareness of smoking’s risks, according to Australian National University anthropologist Simone Dennis, who researched the effects of the original graphic warning label campaign.
But she cautioned against automatically reaching for more graphic warning labels as the solution.
Health warnings about smoking were usually framed around a “particular middle-class version of health” and the assumption that more knowledge will change people’s behaviour, said Professor Dennis, who was not involved in the most recent study.
She said the original graphic warnings were effective in reducing smoking, especially among white, middle-class people, but doubted refreshing the campaign would see a similar reduction.
“I don’t know that the constant articulation of danger is doing anything for the people who are smoking,” she said.
The danger, Professor Dennis said, was that people whose behaviour wasn’t changed by the warning labels tended to be from marginalised groups, and pushing the same line risked marginalising them further.
“If you’re marginalised already, that’s a really heavy burden to bear because you’ve done something that’s perceived to be extraordinarily dangerous,” she said.
“[The campaign] missed them last time, they kept smoking, it’s probably going to miss them again. And that’s consequential because those are the people who are going to die.”