Experts Argue It's Time to Add Graphic Warning Labels to Cigarette Packages

February 13, 2020

COLUMBUS, Ohio – Experts at the Center for Tobacco Research and The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) are making a case for why the U.S. Food and Drug Administration’s (FDA) proposed rule to add 13 new graphic warnings for cigarette packages and advertisements should be allowed to go into effect. This is the second time the FDA has tried to add graphic warning labels; the previous attempt was ruled in violation of the First Amendment in 2012.

In a Viewpoints article titled New Graphic Tobacco Warnings and the First Amendment, published in the medical journal JAMA Oncology, Patricia J. Zettler, JD, and Theodore L. Wagener, PhD, both with the OSUCCC – James, and co-author Tony Yang of George Washington University outlined why the graphic labels can – and should – survive constitutional scrutiny.

The experts argue the images on the proposed labels are factual representations of the potential negative health effects of smoking and are based on research that demonstrates the warnings promote an improved understanding of the consequences of smoking by increasing consumers’ attention to the knowledge of potential consequences.

The experts conclude: “The fate of the FDA’s latest attempt to require graphic warnings has implications not just for the agency’s efforts to address the negative public health effects of smoking, but also for efforts to educate the public about newer tobacco technologies, such as e-cigarettes, and any efforts to assist consumers to make informed choices by requiring industry to provide information.”

In August, the FDA revealed the proposed designs that highlight the negative health effects of tobacco use. The labels include text warnings as well as such graphic images as diseased lungs, feet with amputated toes, and a chest scar from heart surgery.

“Many of the tools that the FDA uses to achieve its public health mission focus on informing patients and consumers. The fate of the agency’s latest graphic warnings effort is important because these warnings have potential to help reduce smoking,” says Zettler, a member of the OSUCCC – James Cancer Control Research Program and assistant professor at Ohio State’s Moritz College of Law. “This effort may serve as a bellwether for the fate of the FDA’s regulatory efforts in other areas.”

Faculty investigators from six Ohio State colleges and the OSUCCC – James have active tobacco-related research through the Center for Tobacco Research.


About the OSUCCC – James
The OSUCCC – James strives to create a cancer-free world by integrating scientific research with excellence in education and patient-centered care, a strategy that leads to better methods of prevention, detection and treatment. Ohio State is one of only 51 National Cancer Institute (NCI)-designated Comprehensive Cancer Centers and one of only a few centers funded by the NCI to conduct both phase I and phase II clinical trials on novel anticancer drugs sponsored by the NCI. As the cancer program’s 356-bed adult patient-care component, The James is one of the top cancer hospitals in the nation as ranked by U.S. News & World Report and has achieved Magnet® designation, the highest honor an organization can receive for quality patient care and professional nursing practice. At 21 floors and with more than 1.1 million square feet, The James is a transformational facility that fosters collaboration and integration of cancer research and clinical cancer care. For more information, visit

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