It's a long way from the Marlboro Man. The image of Barb Tarbox, bald, emaciated and dying at 42 - and the statement "This is what dying of lung cancer looks like" - will soon be among the warnings that grace cigarette packages in Canada. It's tough stuff, but it's also a reasonable approach to a product that kills 37,000 Canadians a year, costs $4.4-billion in direct health-care expenses and would surely be illegal if it entered the market today. Prevention can't just be another easy-to-tune-out lecture.
A state takeover of product packaging to communicate a message may seem like a slippery slope. What is to stop the state, some may ask, from putting graphic warnings about the risks of, say, obesity, on packages of twinkies? The differences are that cigarettes are addictive and kill when used as intended. Besides, packaged food does carry "buyer beware" messages, and as time goes on more information on fat content, salt and calories will be posted in restaurants. And liquor bottles warn pregnant women of the danger of fetal alcohol syndrome. A deadly product such as cigarettes needs extreme warnings.
Britain's warnings, introduced in 2008, are far more extreme than the one featuring Ms. Tarbox. One shows a giant tumour on a man's neck. ("Smoking can cause a slow and painful death.") Another shows a heart being operated on. ("Smoking clogs the arteries and causes heart attacks and strokes.") Perhaps Canada will end up with warnings like these one day. The point is to introduce fresh warnings every so often; the current, pre-Barb Tarbox warnings stem from 2001. The United States is proposing strong package warnings similar to Health Canada's new ones for next year.
Do smokers quit because of packaging? Many Canadian smokers may tune out Barb Tarbox. Some teenagers tempted to smoke may tune her out. Even she, raging against the dying of her light, told this country's schoolchildren of how, sick with cancer, she still couldn't break her addiction. But prominent, graphic new warnings do affect smokers. One study found that Canada's bigger warnings, compared with Britain (before its current, gruesome warnings), caused more smokers here to think twice about their habit. Now the warnings will be bigger still, covering 75 per cent of the package, up from 50 per cent.
Continual innovation is needed to bring Canada's smoking rate down from 21.4 per cent (as of 2008). In the Marlboro Man's heyday, nearly half of this country's adults smoked. The Marlboro Man is, for advertising purposes, dead, as are some of the actors who played him, from tobacco-related causes. It's Barb Tarbox's turn now. May her message live on.