The use of graphic anti-smoking labels could drastically reduce the smoking mortality rate over the coming decades, according to a Georgetown University Medical Center study published Nov. 3 in the international peer-review journal Tobacco Control.

The investigation is the first one ever to estimate the effects of pictorial warnings on cigarette packs on the health of both adults and infants in the U.S. Researchers found these labels could prevent more than 652,000 deaths, 92,000 low-birth-weight infants, 145,000 preterm births and 1,000 cases of sudden infant deaths in the U.S. over the next 50 years.

Currently, the U.S. requires a text-only warning on the side of cigarette packs, although more than 70 other nations have adopted or are considering adopting the World Health Organization’s Framework Convention for Tobacco Control, which calls for front- and back-of-the-pack pictorial warnings.

The study compared changes in the smoking rates of countries that have adopted graphic warning labels with smoking rates in the U.S. using SimSmoke, a tobacco control policy model developed by GUMC Professor of Oncology David Levy.

Levy said this research provides a clear mandate that U.S. officials should make enforcing graphic warning labels a priority.

“Between my study and several other studies that have been done, we now have very strong evidence of the effects,” Levy said. “It shows that this policy that should have been implemented five years ago would have saved many lives, reduced medical costs substantially and had a major impact on the public health of people in the U.S.”

The Food and Drug Administration instated pictorial warning label requirements for all cigarette packages in 2009, but the requirement was struck down in a federal court the same year on the grounds that the labeling unconstitutionally limited the tobacco companies’ right to freedom of speech.

Researcher Darren Mays, an assistant professor of oncology, said they designed the research to generate evidence that would inform the process of tobacco regulation in the U.S. and provide sufficient evidence of the impact of labels on smoking behavior.

“Contrary to the court ruling striking down FDA’s initial requirements, our analysis shows that pictorial warnings will have substantial public health benefits in terms of reducing smoking and preventing smoking-related death and disease,” Mays wrote in an email to The Hoya. “This evidence should be timely as the FDA proceeds to make the case that such a policy is needed and warranted to reduce the burden of smoking in the U.S.”

Levy added that his team was not surprised by the results of the study, citing past studies on the effects of graphic warning labels, including one conducted by GUMC last year linking cigarette packaging to brain activity. However, he said this study goes beyond past studies by looking at actual policy instead of simply assessing the impact of warning labels on smoker behavior.

“We knew what to expect. There were no surprises there. It’s based on past studies on this problem, so that idea was to come up with what would be the effect of a policy that was supposed to be implemented, but was not implemented,” Levy said.

Smoke-Free Georgetown founder Henry Callander (COL ’18), who successfully launched a petition in October to hold a student-wide referendum banning smoking on campus, said he hoped the study will help policymakers implement measures to deter smokers from purchasing cigarettes.

“If graphic images on cigarette boxes decreases the amount of people who smoke cigarettes, Smoke-Free Georgetown believes that these types of graphics would only be a good thing for a more positive future global health,” Callander wrote in an email to The Hoya.