A sample of the graphic warnings the FDA would require printed on cigarette packs and cartons. (Screenshot: FDA)
A UNC researcher says the United States has a lot of catching up to do when it comes to informing consumers about the potential health risks of products they’re buying.
Depictions of smoking-related health problems, including images of rotting teeth and tumors, are printed on cigarette packs sold in Canada. And inside, explicit health warnings are printed on each cigarette.
Food product labels in most Latin American countries are on the front of packages and say whether they are high in salt, sugar or saturated fat.
The U.S. is behind other countries in requiring easy to understand nutrition and warning labels that draw consumers’ attention, said Marissa Hall, a UNC-Chapel Hill behavioral scientist.
“Warning labels are a surprisingly powerful tool for changing behavior when they are well-designed,” Hall said Thursday. Labels with icons or graphics are the most effective, she said.
Hall gave a talk about useful labels on alcohol, tobacco and food as one of the recipients of a campus award recognizing achievements of junior faculty.
As it happens, the United States is in the midst of a long process of updating its rules for tobacco labels to include graphic images and health warnings on packages and cartons of cigarettes. Tobacco companies have sued to stop the federal Food and Drug Administration rule, and litigation is ongoing.
Studies have found that graphic cigarette package warnings help people quit smoking, she said. Other studies have found that graphic tobacco labels could avert thousands of deaths in the US over time.
The FDA has also proposed a rule that would require packaged foods to have nutrition labels printed on the front, with information whether salt, sugar and saturated fat content is low, medium or high.
Labels are important because they deliver information to consumers right when they need it, Hall said. It’s also important to get the labeling right, because weak labels are hard to change.
Hall and a colleague created UNC Mini Mart, a research space that looks like a convenience store. One UNC Mini Mart study found parents were less likely to purchase sugary drinks for their children when the bottles had pictorial warnings about heart damage and type-2 diabetes.
Marissa Hall, behavioral scientist at UNC Chapel Hill, Oct. 23, 2025 (Photo: Screenshot)Hall also said the U.S.’s required warning label on alcohol hasn’t changed since 1989, leaving plenty of opportunities for upgrades.
Alcohol warning labels don’t follow best practices, she said. They’re on the back or side of the package, they’re long, hard to read messages with no images or icons.
In a recent study that’s under review, researchers found that fewer than one-third of people who drink alcohol said they read the warning in the previous three months, Hall said. Only 4% were able to remember all five topics in the warning.
Researchers are in the middle of a study where people bring their own alcohol containers to the study office to have more prominent labels attached to the front. People in the control group will have a barcode attached.
“Ultimately, this will provide some of the strongest evidence of whether or not these new evidence-based warning labels would reduce drinking,” she said.
In an interview, Hall said it’s a step forward for the FDA to require nutrition labels on the front of packaged foods, but the label design is not ideal.
There’s evidence that people struggle to interpret numbers, she said. The proposed labeling would not include icons, images, or anything that conveys a warning.
“It’s a missed opportunity to signal something in a different way,” she said.
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