A decade after lung-cancer death, Barbara Tarbox delivers one more graphic warning to smokers

Before the age of reality shows and everyday people exposing themselves to public scrutiny, Barbara Tarbox of Edmonton revealed herself to the world as perhaps no one ever had.

Almost a decade after her death from lung cancer, Tarbox's way of forcing us to see the stark reality of the effects of tobacco is still getting in smokers' faces.

Many cigarette and small cigar packages going forward will feature a photograph of the emaciated, dying Tarbox covering three-quarters of their surfaces, The Canadian Press reported.

The new, larger images graphically showing the the effects of smoking, including a cancer-infected mouth, were first announced in April.

"This initiative continues our efforts to inform Canadians - especially young people - about the health hazards of smoking," federal Health Minister Leona Aglukkaq said in a news release.

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Health Canada has required health labelling on tobacco products since 2000 and increasingly ratcheted up their graphic nature over the objections of tobacco companies.

Statistics Canada reports smoking rates have fallen dramatically in the last 10 years, according to The Canadian Press.

Last year, 20 per cent of Canadians smoked, down from 25.9 per cent in 2001. Among teens aged 15 to 17, the rate was cut by more than half to 9.4 per cent from 20.8 per cent, while young people aged 18 and 19 went to 20 per cent from about 33 per cent, StatsCan reported.

However, a British study last year suggested graphic warning labels used in the U.K. had no effect on smoking behaviour, according to a post by Dr. Michael Siegel on his Tobacco Analysis blog.

"The only significant change in behaviour was that more adult smokers reported using a technique to avoid seeing the messages," the study concluded.

"It therefore remains to be seen whether these emotional responses are translated into behavioural change in the future. Among young people, the impact of picture health warnings was negligible."

Siegel commented the impact of graphic warning labels was likely to be greatest when they were first introduced "because of the shock value of the images. This immediate effect is likely to wane over time."

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Nevertheless, it's hard to deny the impact of seeing graphic pictures such as the skeletal Tarbox, a former model, lying on her deathbed at age 42.

According to her CBC News obituary, Tarbox was diagnosed with stage-four lung cancer in September 2002. She had started smoking at age 11.

Instead of caving in to the evident death sentence, Tarbox became a tireless activist, giving media interviews and visiting schools across Canada to warn young people not to give in to peer pressure to start smoking.

The best evidence she presented was herself, her bald head and deteriorating appearance, preserved on videos of her talks.

"Look at my arms," she told one group of Edmonton children. "I don't know if you can see it but it's where the bones stick out.

"You know what? The bones stick out of every area of my body now. My feet, my legs are blue, or they like to call it cyanotic, which is like a purple tinge. And you know what happens? When your tissues start to die, they turn black ... And there isn't a perfume on the market that can hide that smell. All the result of smoking."

In March 2003, Tarbox achieved her goal of bringing her message to 50,000 Canadian teens. She made her last public appearance at an Edmonton school on April 17, weighing 85 pounds.

Tarbox died a month later in an Edmonton hospital.