Stop us if you’ve heard this one before: A popular product promises relaxation and reward, with a hint of sex appeal. Experts say it causes cancer and should carry a warning label. Many people say warnings won’t work. The industry is not so excited.
Does it ring?
Since the day in 1963 when Minister of National Health and Welfare Judy LaMarche announced in the House of Commons that smoking causes lung cancer, Canada has been among the world leaders in anti-smoking initiatives, including warning labels.
Sixty years later, experts warn that alcohol is a cancer risk and its packaging should be treated similarly.
While the two stories are similar, people who have spent years studying or promoting anti-smoking advocacy say alcohol labeling shouldn’t be played the same way — hard and gradual.
“I think we’ve learned a lot from the endlessly long, drawn-out steps,” said Jeffrey Fong, a professor at the University of Waterloo and a researcher at both the Ontario Cancer Research Institute and the International Tobacco Control Policy Evaluation Project.
“I think we can do what’s right.”
A trendsetter
Starting with LaMarsh’s warning — which came a year before the famous US surgeon general’s report confirming that smoking causes lung cancer in men — Canada has been at the forefront of smoking regulations.
Garfield Mahood, then executive director of the Non-Smokers’ Rights Association, displays a pack of cigarettes at a press conference in Ottawa in 2005 (Fred Chartrand/The Canadian Press)
It was the first country to ban smoking on all domestic airline flights in 1987 and international flights on its domestic airlines in 1994. Calgary was the first city to host a smoke-free Olympics in 1988. Canada was the first country that introduced pictorial health warnings on cigarette packs in 2001.
But none of this was easy.
Garfield Mahood, who proudly recounts his decades with the now-defunct Non-Smokers’ Rights Association, says getting specific, graphic warnings on cigarette packages has been a long battle against hesitant politicians and contentious tobacco companies.
“For God’s sake, they didn’t want the packages to have those warnings in Canada,” he said.
Canada has had several phases of tobacco warning labels.
Before the late 1980s, there were voluntary warnings, including a request to “avoid inhalation”.
Then came the first mandatory warnings:
- Smoking reduces life expectancy.
- Smoking is the main cause of lung cancer.
- Smoking is a major cause of heart disease.
- Smoking during pregnancy can harm the baby.
Mahoud said early warnings were “camouflaged” on the packaging so no one would notice — so much so that he said any resistance from the public was minimal. They just didn’t register the warnings, he said.
Thanks in large part to his organization’s work, Mahoud said, bolder warnings in the early 1990s, such as “Smoking can kill you,” were moved to the top of packages in graphic black and white instead of the brand’s chosen colors .
WATCH | New warning labels on cigarettes in 1993:
‘Cigarettes cause cancer’: new warning labels in 1993
Every cigarette pack will soon contain hard-to-ignore warnings about the risks of smoking. Aired on CBC prime time news on March 19, 1993.
“Ottawa is trying to make it impossible for a smoker to say he didn’t know how much harm smoking can cause,” the CBC’s Peter Mansbridge reported in 1993.
Pictorial warnings first appeared in 2001, with several iterations since then, including the standardized plain packaging used now.
Cigarettes sold in plain packs are seen in Ottawa on Thursday, October 17, 2019. (Justin Tang/The Canadian Press)
Tobacco companies are not involved
Tobacco companies disagreed with new rules introduced in the 1980s and called the larger warnings in 1993 “bullying”. They said the tag didn’t work.
“The claim has always been that this is the measure that will work, that this is the measure that will lead to an accelerated rate of decline,” Rob Parker of the Canadian Tobacco Growers Council told CBC News in 1993. “And that it didn’t happen.”
In 1995, the Supreme Court of Canada ruled that many of the current tobacco rules were unconstitutional, including the warnings it ruled a violation because they were not stated and therefore appeared to come from the companies themselves. Some companies added attribution afterwards.
WATCH | From the archives, legal victory for Big Tobacco:
Court victory for Big Tobacco
Supreme Court rules government restrictions on cigarette advertising unconstitutional.
In 1997, Parliament passed the Tobacco Act, reimposing advertising restrictions and allowing the government to regulate cigarette packaging. The companies also fought this, but this time they lost in the Supreme Court unanimously in 2007.
As for the average consumer, whether in 1988, 1993 or 1995, Canadians who spoke to CBC News about packaging changes were almost universally dismissive.
“I’m enjoying myself and I’ll leave when I’m ready,” said one woman.
I don’t even read what it says on the cigarette pack,” said a man.
“They will all taste the same inside,” said another.
WATCH | In 1988, smokers were unimpressed by warning labels:
Smokers were unimpressed by cigarette warning labels in 1988
The CBC reported on the Windsor, Ontario Tobacco Control Act of 1988
Whether or not the warnings ever worked for those people, “there is no doubt that the concentrated campaign against smoking has had a significant impact,” a CBC News report said in 1995 — and the trend continues.
In the 1960s, half of Canadian adults smoked. By 1995, it was less than a third. Today it’s about one in ten.
Fong, a professor at the University of Waterloo, says studies show that labels work — particularly the graphic ones used today.
“The graphic warning labels that we have evaluated in Canada and many other countries have demonstrated a strong impact on increasing the effectiveness of these warning labels,” he said. Canada, the United Kingdom, Malaysia and Kenya are among the places that have seen an impact, he said.
Mahood estimates that Canada’s policies have saved millions of lives in this country and in other countries that have followed Canada’s lead.
Alcohol Labeling Tutorials
So what can experts calling for cancer warnings on alcohol learn from the anti-smoking lobby?
Specificity and severity are important aspects of warnings, Fong said. For example, alcohol companies now warn that if you are pregnant, you should not drink.
“Well, this is just the beginning because we know a lot more about specific diseases, whether you’re pregnant or not.”
Specific types of cancer or increased risk of heart disease or stroke should be mentioned on individual labels, he said, as should guidelines for how much a person who wants to cut back should drink.
Awareness doesn’t go from zero to 100 percent, Fong said, but it can go from 25 percent to 38 percent, for example.
WATCH | Most people are not aware of the risks of drinking:
Is your drinking risky? Why there is a big push for warning labels
There is overwhelming evidence that alcohol causes cancer, yet most people are unaware of the risks that come with drinking even a small amount. CBC’s Joanna Roumeliotis breaks down the latest information and the growing push for mandatory warning labels.
Mahood has thoughts on labels – avoid large blocks of text and don’t say something “may cause cancer” when you can say it “causes cancer”. But his biggest message to labeling advocates is the amount of work it will take to get anything done.
“I think it’s going to be just as difficult as the fight against tobacco unless there’s strong advocacy, and it’s going to have to be strong advocacy, not the warm and fuzzy messages that come from health agencies.”
He said that if they didn’t play “strong, sometimes charismatic hardball”, nothing like the tobacco warnings would happen.
“The alcohol industry is just going to stuff them into politicians’ offices,” Mahoud said.
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