Will new government ads scare smokers into quitting?

The government has stepped up its fight against tobacco with a graphic campaign, but should its shock tactics also be applied to junk food and alcohol, asks SHÂN ROSS

HIS head tilted back as he inhaled the first draw on his cigarette: Ammar Othman looked the picture of relaxation as he sat at a table outside the Angels Espresso café yesterday. But Ammar was blissfully unaware that smokers like him are the target of the government's latest health campaign. As of yesterday, packets of cigarettes on sale in the UK featured graphic images such as large neck tumours and rotting lungs.

The 15 photographs also include a corpse in a mortuary, a child inhaling a smoke cloud, a drooping cigarette, to signify the risk of impotence, and are the result of the government's decision to "up the ante" and take a much tougher approach in its fight against the killer addiction.

The photos, accompanied by a written health warning, replace the previous warnings introduced in January 2003, although the messages "smoking kills" and "smoking seriously harms you and others around you" continue to appear on the packets.

The Department of Health says the written warnings have been a success, with research showing more than 90,000 smokers had been motivated enough to call the NHS quit line because of them. It also points to the fact that researchers reported smokers in other countries said the graphic medical textbook- style photos had certainly had an impact.

Canada was the first country to introduce picture warnings in 2001. Research a year later found 31 per cent of former smokers said the images had motivated them to quit, while 27 per cent said they had helped them to remain non-smokers, according to the department. But the crucial question is: Will it work, or will smokers just become blasé and carry on as normal?

Dr Mary Brown, a psychologist at Robert Gordon University in Aberdeen, says the government's approach is too blunt, only emphasises the negative and does not differentiate between groups of smokers.

"Research on the use of fear as a means to persuading people to take a certain course of action found that it only works in specific situations, for example if you don't jump off that building you will burn to death in a fire.

"But there is further research showing that people with addictions 'rationalise' their actions and think diseases such as lung cancer will never happen to them."

Dr Brown said a more beneficial strategy would be to emphasise the positive. "Instead of using photographs of tumours, I believe it would be better to have a clear message on cost and what pleasures could be enjoyed with the money.

"Putting something like '£200 a month on cigarettes or a brand new top-of-the-range iPod' would have an immediate appeal to a wide range of people.

"However, the government also needs a much more sophisticated plan of action, which gets inside the mind-set of a plethora of smokers – from the 14-year-old smoking because all her friends do, to the 84-year-old pensioner who says it never did him any harm – rather than the 'one-size-fits-all' shock tactics.

"Older smokers will need to decide for themselves when the time is right and, when they do, there need to be sufficient support programmes using a range of therapies from personal advisers, hypnotism, nicotine patches and aromatherapy."

Gerry O'Farrell, the creative director at The Leith Agency, one of Scotland's leading advertising companies, agreed that the government's campaign had to have something positive to offer.

"The government has decided to use these images because they have done a lot of research and decided to be as hardcore as they can be. But while smokers might a get a jolt when they first see them, after a while they won't even notice them.

"As an ex-smoker myself, you've got to bring yourself to the point where you want to stop. But anything might nudge you along – a comment from a child or a friend, or something you read in a book.

"But the crucial point is that there needs to be an incentive to smokers."

Convincing smokers to quit is a continuing battle with addiction, but could the same tactics be used to tackle the nation's obesity problem, with photos of bloated fatty hearts printed on junk food?

Dr Rafe Bundy, a lecturer in nutrition at the University of Glasgow, urged caution.

"Obviously with smoking there are no beneficial effects at all, it is linked to cancer and it is a complete 'no-win' situation. It would be difficult for anyone to argue against the facts of this latest government campaign.

"But we need to be extremely careful not to lambast certain foods because you could have someone who is leading a perfectly healthy lifestyle with a good diet and lots of exercise yet enjoys a hamburger or a pork pie as a treat. Things have to be put in context.

"With alcohol, too, we can say that too much is bad for you, but that a little might do you good. So it would hardly be fair to slap a picture of a diseased liver on a bottle of Merlot when someone is only drinking a couple of glasses of red wine a week."

Zoe Hellman, a company dietician for WeightWatchers UK, which runs nearly 7,000 slimming support groups across the country, was also against shock tactics on fattening foods.

She said: "It is not fair to blame food alone for health problems and it is definitely not a good idea to put such horrible pictures on packaging.

"Doing something like that creates a totally wrong image of what healthy eating is about and fails to take into account that what we promote as a healthy diet also includes a bit of what you fancy."

But Dr David Haslam, the clinical director of the National Obesity Forum, an independent charity working towards the prevention and management of obesity, said he would not oppose shock tactics on certain food packaging.

"Something like pork scratchings, which are full of salt and fat, have nothing to redeem them, so I don't see why there shouldn't be a damaged heart or furred-up artery on the packet.

"As for saying some people eat them only for a treat, well, I would say that such pictures are not aimed at them so wouldn't have an effect on them but might well do other people a lot of good.

"The food industry will bitterly oppose this, but the current situation means they talk a lot but are actually doing all they can to slow up improvements."

A spokeswoman for the Food and Drink Federation said: "Firstly, it is wrong to compare tobacco with food. FDF believes that negative messages about unhealthy eating habits just don't work – much better to promote a positive approach to food and health.

"It is important that consumers have a choice of products, from which to construct a diet appropriate for their own individual needs."



'Stop the sale of cigarettes'

AMY MCLEAN

21, from Edinburgh, an auxiliary at the Western General Hospital.

"I think these horrible photos would quite possibly make me stop smoking. I only smoke when I'm stressed out to make me feel better, but these photos do frighten me. I spend £200-£300 a month on cigarettes, which I know is a lot so maybe this will get me to quit."

NICK JOHNSON

45, motorcycle promontory, travelling between the UK and Spain.

"The picture which has the most effect on me is the one of the little girl breathing in smoke, rather than all the tumours. People should be thinking of their kids. But this type of campaign doesn't work and the government has got it all wrong again. The smoking ban just meant that people who used to smoke in pubs do it at home. If they want to stop people smoking they should stop the sale of cigarettes altogether. I'm in the process of trying to stop, but this is lot of rubbish."

MARK FERGUS

37, from Peebles, a development chef for Belhaven.

"I keep saying I'm going to stop and I think these pictures will put me off more than anything else in the past. The main images from all the anti-smoking campaigns which has stayed with me was the one where you saw cigarettes smoke coming out of a baby's mouth. I'm older so it's more difficult to stop, but perhaps this campaign will help the younger age group not to start or give up sooner."

SAM ROBERTS

32, a mother from Edinburgh.

"My dad had cancer of the oesophagus and we nearly lost him, but it hasn't stopped my smoking. I started at school because of peer group pressure but the photos make you think. Despite that, it is still too much of a habit for me to stop. I only smoke in a specific room at home and with the window open, so that's a start."