The weird and wonderful world of cigarette packaging

By Kirsten Bell

Two weeks ago, The Guardian featured an article about Tom Fraine, the British man who inadvertently ended up as the ‘dead’ body on the ‘smoking causes heart attacks’ label. In describing his experience of how he came to be a cigarette packaging model, Fraine recounts: ‘I was offered €200 and asked to come to a disused hospital on the outskirts of Berlin. They painted my face grey, put me in a body bag and took me to the morgue. Being in a body bag really freaked me out, especially when the photographer zipped the bag up fully and whispered: ‘This is for Dresden’, before unzipping me. He had a dark sense of humour’.

I was offered €200 and asked to come to a disused hospital on the outskirts of Berlin. They painted my face grey, put me in a body bag and took me to the morgue. Being in a body bag really freaked me out, especially when the photographer zipped the bag up fully and whispered: ‘This is for Dresden’, before unzipping me. He had a dark sense of humour.

Fraine, who doesn’t smoke, only discovered that he had become the face of the ‘smoking causes heart attack’ label (see left) in 2016, when he got an email from a German friend of a photo of a pack of Marlboros accompanied by the question ‘Is this you?’  A quick trip to the local shop confirmed that his face (albeit a pasty grey version) was now plastered all over cigarette packets throughout the UK and Europe. ‘I was constantly seeing my face in pubs, on the street, in shops’, Fraine notes; ‘It was weird’.

For Fraine and his friends and family, the cigarette packets bearing his image became a source of amusement and entertainment – ‘over time my friends started sending me things they found: there were sad poems on Facebook about the dead guy on the cigarette packet, and I saw a bag at London fashion week that was made up of tobacco pouches with my face on them’. His mum, when asked about her children and what they did for a living, could readily point to cigarette packets lying on the ground and proclaim: ‘That’s my son’.

As Fraine’s story suggests, many of the images on cigarette warning labels have an intriguing backstory – something I first
became aware of when obtaining copyright approvals to reproduce cigarette warning labels for a comparative study on the ways smokers in Canada, Australia, the UK and the USA engage with their cigarette packages. In the process of trying to obtain permission[1] to reproduce various warning labels bearing a diseased heart (see above), I realised that they all traced back to a single smoker from one research lab in Alberta, Canada.

Who was this smoker whose heart had ended up on warning labels around the world as the stereotypical ‘smoker’s heart’?  Sadly, I wasn’t able to obtain an answer to this question because the pictures were taken decades ago and the relevant personnel had all retired, but they got me thinking about the images themselves and their global circulation. We increasingly traffick, it seems, not just in organs, but images of organs – and of bodies in various states of disease and decay.

While Fraine’s account shows that not all of these images are ‘real’, the recent furor surrounding the ‘smoking causes strokes and disability’ label (see left), with its depiction of a man in intensive care, suggests that some of the images are all too real in terms of how viewers respond to them.

Last year, The Mirror published an article about Jodi Charles, an Essex woman who believes the picture on the warning label is of her father, who died in 2015 of non-smoking-related causes, and who, she says, would never have given his consent for his image to be used in this way. Her father does indeed bear a resemblance to the man on the warning label, but so too does the Welshman Kenneth Bullock, whose wife, Dorothy, after reading Charles’ claims in The Mirror, insisted that the picture is of her own spouse. Complicating matters further, yet more contenders have emerged, with a Spanish man claiming that he is the subject of the photo and a Belgium man coming forward to declare that it’s actually a photo of his own father, who died eight years ago. In essence, while no one seems keen to claim credit for Fraine’s hokey ‘dead man’ at the morgue, the stroke warning label looks like (and presumably is) a real, named person – a father, a grandfather, a husband – a human being whose personal suffering has seemingly been exploited in the name of reducing smoking.[2]

Of course, medicine has long exploited bodies (especially impoverished and ‘deviant’ ones), and images of such, for the purposes of diagnosis and training – as Richard Barnett illustrates in his fascinating book The Sick Rose, Or, Disease and the Art of Medical Illustration. But the images on cigarette packets, intended as they are for public consumption, have a rather different educational purpose, epitomising what Deborah Lupton terms the ‘pedagogy of disgust’.  Although designed to inform smokers about the health effects of smoking, the gruesome nature of the imagery suggests that their purpose is persuasive as well as informational. If the Marlboro Man[3] marketed smoking, these bodies – some wittingly, others perhaps unknowingly – are intended to do precisely the opposite.

Elsewhere, I’ve illustrated the ways in which tobacco control imagery relies on staged displays of the body as spectacle, suggesting that they share a lineage with images of bizarre curiosities and ‘freakery’ in the Victorian era. Indeed, a blogger photographer has recently discussed his ‘strange fascination with the images of disease and death you get on packets now’, dating his interest back to a childhood spent skimming his mother’s illustrated medical guide for pictures of gruesome diseases.[4]

Certainly, research I have conducted with fellow anthropologists Simone Dennis, Jude Robinson and Roland Moore suggests that if packets bear the visual marks of their encounters with agents aiming to inscribe them in certain ways (as ‘desirable’ on the part of the tobacco industry and ‘dangerous’ on the part of the government), they also bear the less obvious marks of other encounters and circulations. We see this clearly in Fraine’s friends’ and family’s amusement when they stumble across cigarette packets bearing his ‘dead’ body and the distress of those who are convinced that the stroke label portrays a loved one’s personal health crisis. These reactions indicate a more complex engagement, one where images produce a variety of responses beyond those intended by policy makers and get taken up in all sorts of fascinating ways.

As an article in The Guardian reports of Dennis’s Australian fieldwork, some men actively seek out packs bearing the ‘smoking harms unborn babies’ label and blue-eyed smokers might avoid packs bearing the ‘smoking causes blindness’ label (see left), picking and choosing packets based on how personally threatening they are. I observed similar responses in my fieldwork in Vancouver – one woman talked of purposely asking for packets with the ‘smoking causes impotence’ label before it was dropped from circulation, and several men spoke of actively avoiding it; various smokers also swapped specific hated labels (especially ‘the tongue one’ – see below) for those with less grotesque images. As Dennis notes in The Guardian article: ‘It’s almost like the cigarettes in particular packets had different qualities’.

My colleague, Rebecca Haines-Saah, and I also heard countless dissections of the Canadian labels: evaluations of their relative credibility and fakeness, with the images often perceived as akin to ‘blood and guts’ shows on television. Conversely, they were also described in ways that transformed images of disease and debility into innocent and innocuous activities: blood pooling in a toilet on the bladder cancer label (below) became a picture of ‘that time of the month’; the image on the stroke label of a male carer physically supporting a wheel-chair-bound man in a bathroom (below) became a gay cottaging scene;[5] a cancerous tongue (below) became a mouthful of cottage cheese.

Smokers’ responses, in other words, represent all the creativity and ingenuity that one might expect of human beings confronted with an attempt to limit the meanings of a complex embodied practice to which they are wedded. While we might be tempted to dismiss these responses as rationalizations (writ in scientific language as ‘risk denial’, ‘optimism bias’, ‘self-exempting beliefs’, etc.), they provide us with important insights into human sense-making processes that are missed entirely by the question ‘do cigarette warning labels reduce smoking rates?’, which is the primary way this topic has been studied to date. At the very least, it tells us that while ‘a picture is worth a thousand words’, we aren’t necessarily seeing the same ones.


[1] Did I obtain permission to reproduce the labels here? Well, no, largely because I shouldn’t have had to get it in the first place. The countries whose labels I have reproduced here all have ‘fair dealing’ clauses which specifically exclude reproductions for the purpose of research, education, parody, satire, criticism or review from the usual copyright requirements. Sadly, most publishers, worried about being sued, force academics to obtain such copyright approvals regardless. The consequences are often farcical. In one case, in order to obtain permission to produce a tobacco control poster created by the NHS for Rebecca Haines-Saah’s chapter “Pretty Girls Don’t Smoke” in Alcohol, Tobacco and Obesity: Morality, Mortality and the New Public Health, we had to obtain separate copyright permission from the NHS, the photographer, and the model, who was reluctant to provide it as the picture portrayed her in an unflattering light – although she ultimately agreed to do so for a sizeable sum. In the context of a separate co-authored paper analysing cigarette warning labels, we were unable to get permission to reproduce one label because the Canadian government allowed us to reproduce the text but the photographer refused to provide separate approval for the image as soon as she realized that we were critically analysing the label.
[2] In response to the furor, the European Commission has insisted that ‘all individuals depicted in the library of picture warnings were informed and gave their consent. Any similarity with other individuals is purely coincidental’. In other words, they might be cheap (€200, the sum they paid Fraine to get naked in a morgue, is significantly less than I have forked out for permission to reproduce many of the cigarette warning labels), but they want to make it clear that at least they are honest!
[3] Men, actually; according to Wikipedia there were numerous Marlboro Men, at least four of whom died of smoking-related diseases, so they are now as much an anti-smoking advertisement as a smoking one.
[4] This was also a favoured activity amongst pubescent girls in the late 1980s at my high school in northeast Australia. Skimming the medical encyclopaedias in the library was seen to have similar entertainment value to watching horror movies at sleepovers, another popular pastime.
[5] It’s worth noting that the accompanying text: ‘a single stroke can leave you helpless’ doesn’t necessarily clarify matters.

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