Still no big picture vision at the CMAJ when it comes to tobacco

The Canadian Medical Association Journal has popped up in the news again and this time criticizing the government for delaying instituting new warning labels on cigarette packages. (Globe and Mail coverage here and original CMAJ editorial here).

Essentially the story is that new labels have been developed but have not been rolled out which will threaten our leadership position in tobacco control as well as raising concerns that the same old warning labels no longer influence smokers as much as they should.

In terms of continuing smokers, this might be a reasonable argument but one would think that the other prime target (potential smokers) would not need new labels since they have yet to see the old ones. Some continuing smokers who then quit do cite the labels as factors in quitting. This posting is not to question the effectiveness of the labels but to question why an institution that supposedly cares about smokers will be so strong on this and yet utterly ignore tobacco harm reduction which if properly promoted would do much more good than warning labels.

(But of course I cannot help but opine slightly on the label question. As far as those new smokers who tend to be young -they also tend to be attracted to smoking precisely because it is risky and therefore the labels might in fact attract them. Overall, I suspect the effects of the labels are not unitary and vary from one individual to another. The funniest thing about this all is that these labels are deemed so important and then once in place the packages themselves are put into the dark market so that the only way you get to see the label is by deciding to purchase the product. The joke then is that the message not to buy the product is only available to you if you buy the product. Or perhaps this is the ultimate government revenue joke in managing to discourage the use of the product that you purchase which keeps the taxes coming in even if you throw away the pack.)

But to return to the point at hand which is that this health oriented organization moaning about how concerned they are about tobacco associated outcomes and then deciding only to endorse solutions that are politically correct and not include those that could save many lives. It seems that only smokers who quit are worthy of consideration. (For more on CMAJ see here and here).

If I were to apply the same argument they do to explain the government inaction on new labels (possible tobacco industry influence) I would accuse them of possibly being in the pocket of pharmaceutical interests who have so much invested in their revolving door quitting smoker customers returning over and over again after failing at using their cessation products.

-Paul L. Bergen

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