Once in a while, the media or a government agency will say something that deeply offends ostomates.
UPDATE from Health Canada (July 23, 2018 @ 4:36pm) :
Such was the case when Canadian news articles began reporting on the testing of new cigarette warning labels, one of which featured an ostomate.
To say that my private messages and Twitter feed exploded was an understatement, and I’ve had numerous requests to let Health Canada know that I am outraged that they would stigmatize ostomies and offend my community.
Table of Contents
A History Involving Ostomates
This isn’t the first time something like this has happened. Several years ago the CDC ran a similar campaign stating the risks of smoking and it features two ostomates (in two separate ads) who were sharing their negative experiences of living with an ostomy as a result of smoking.
A lot of pressure was put on the CDC to have the ads removed or revised, and they did end up modifying the message. In that case, I was in support of the revisions because I felt it put too much negative emphasis on having an ostomy, rather than why they had the ostomy to being in (smoking).
That said, these were patient testimonials, and nobody should have the right to undermine their experiences (I did publically reach out to one of the people featured to see if I could help by offering stoma care tips).
Health Canada’s Proposed Labels
But the new Health Canada warning label is different than the CDC ads and there is no testimonial.
For example:
The proposed labeling is part of an open consultation (including open to the public) to, “get feedback on the proposed measures to standardize the appearance of tobacco packages and certain tobacco products.” according to Health Canada (SOURCE)
Why Put Warnings on Tobacco Products?
Warning labels on tobacco products sold in Canada are nothing new and they can be quite graphic (SOURCE). They’ve been around for decades, and their effectiveness in both raising public education about the dangers of smoking and their ability to influence people to quit has been studied for decades as well.
Some studies show that these warnings cause smokers to think of risks and can encourage them to stop (SOURCE, SOURCE, SOURCE), even across dozens of countries who use similar labeling strategies (SOURCE).
These new mock-up labels have also been tested in focus groups, and their impact on teens showed that they offer education and pause to think – especially when the message is to the point and realistic (i.e. like the ostomy one).
As the Toronto Star reported, “Youth participants, aged 15 to 19, noted learning new information in the focus groups, like the fact colorectal cancer could result in reliance on a colostomy bag.”. (SOURCE)
To me, this seems like a great idea that the public (and ostomates) should be supporting.
So Why the Outrage?
If these labels are meant to educate, and they’ve been shown to be effective at getting people to quit smoking, why all the outrage over the ostomy bag?
That was my first thought when I started getting tweets and private messages about it.
Surely, if so many people were upset there must be a good reason – right?
But as I looked at the specific warning label in question, I found nothing to be offended by.
Nothing I felt was stigmatizing to ostomates. Nothing that made me feel bad about living with an ostomy. Nothing exaggerated or made to seem different from what life might look like with an ostomy bag.
It simply shows a person with an ostomy bag – the image is similar to many I’ve seen on social media that get praised and shared around!
I’ve seen comments like these and have scratched my head for the last few days trying to understand why people are so upset:
“This enforces the already terrible stigma there are regarding bags and stomas! So annoying! The wording is very offensive…”
“…it makes a mockery of everything ostomates and advocates are achieving breaking the stigma attached to having a stoma bag. I find the wording insulting as well.”
“It’s the wrong way to promote quitting and offensive to Ostomates”
“This is disgraceful ….. [the] federal government needs to get their facts right about stoma bags before putting them on cigarette packages…”
“Disgraceful and out of order very upsetting for lots of ostomates”
As I read these comments and then look back at the warning label, it’s as though I’m looking at something totally different from what the comments refer to.
The label stated a fact: “Cigarettes cause colorectal cancer”.
It then stated a possible reality of having colorectal cancer: “You may need to use a bag as a toilet for the rest of your life.”
With the message, “You can quit. We can help.” that includes a phone number and website where someone can go to find resources to help them quit.
The image is that of an ostomate with an ostomy bag on their side. This person may or may not be an actual ostomate, but I will note that the ostomy appears to be on the right side of the person, which would indicate an ileostomy, rather than a colostomy.
It gets to the point (smoking causes colon cancer which may result in having an ostomy) without actually attacking ostomates in any way. And unlike with the CDC ads, this one doesn’t show an ostomate struggling or complaining about the smell or difficulties they’re having.
There is no hint that having an ostomy is “worse than death” or that it’s a “worse case scenario”, but it is being shown as something that could happen if you end up with colorectal cancer (which is still true).
Heck, the photo shown looks tame compared what my abdomen looked like after surgery!
If the warning had been misleading or intentionally made it seem like living with an ostomy is terrible, then I would have something to say about that. All of us would.
But I just don’t see it here.
What If You Are Offended by It?
Many people don’t agree with me, and I respect that. But I would like you to consider something if you feel offended by that warning label.
Are we hurt by how other people may perceive our ostomy or are we hurt by how we feel about living with an ostomy?
I think it’s important to ask ourselves why we feel offended by things like this. The label is targeting smokers and using the facts to help inform them.
I repeat: The goal of these labels is to inform people about the risks of smoking and provide them with an incentive to quit – saving lives in the process. It is not about shaming ostomates.
And I get it: We value our ostomy because it likely saved our lives, and it also allowed us to regain a quality of life we never imagined. Nobody is challenging that and the warning label does not elude to what actually living with an ostomy can be like (I don’t believe it ever intended to).
Promoting positivity when living with an ostomy is key to my own advocacy and I’m here to support anyone who has an ostomy. But for those who know me, it also means I don’t sugar coat the realities of life with an ostomy (including having blockages, leaks, and pouch odors).
And while we may see ostomy surgery as a treatment option for illnesses we had no control over; a life-saving option after an accident or emergency; a life-improving option for someone with cancer; we should do what we can to promote the avoidance of disease and surgery influenced by lifestyle choices – like informing smokers of their risks.
If you feel hurt or offended by these warning labels, you can certainly voice your opinion to Health Canada, and I encourage all Canadians to share their thoughts with Health Canada about these newly proposed labels.
But more importantly, I’d like you to think about why a warning label that is stating a fact causes such a negative reaction in you.
Thoughts from Other Ostomy Advocates
Many of my fellow ostomy advocates do not share my opinion (and that’s OK!), but I’m glad they are starting discussions around it.
I am glad to see that not everyone is outraged by these campaigns, including Fight Colorectal Cancer, a US advocacy group that works with many ostomates. They offered a rational and level-headed response to the CDC smoking ads which aired several years ago.
What Can We Do from Here?
Firstly, I encourage you to share your thoughts and feelings about these proposed labels.
We can’t move forward as advocates and patients living with an ostomy if we don’t understand the reasons behind our motivations or rationale.
I will be opening up a thread on the VeganOstomy Community Forums to give people an opportunity to openly discuss this topic. I hope that you’ll join in! You can also leave a comment below.
Secondly, I’d like you to stop and think. Knee-jerk reactions to things like this are often short-sighted and unplanned. Something we may take offense to one minute may actually be something we agree with after giving it some thought.
If there’s something specific about the label that rubs you the wrong way (the wording, the image, misinformation, etc.), please let Health Canada know.
If you have a more effective way to help educate people about the risks of smoking, please make those ideas known!
I want to be clear that I’m not trying to start an argument within the ostomy community, nor am I interested in debating over the rights someone might have to smoke. I would love for us all to have a collective voice that benefits everyone in meaningful ways, and that starts with open discussion.
Thank you for reading this.
If you need help to quit smoking, please click HERE.
Note: Already have an ostomy and are looking for some direction? I’ve got many helpful articles and videos available HERE!
References
- Consultation on the proposed Tobacco Products Regulations (Plain and Standardized Appearance) – Health Canada
- CDC alters anti-smoking ads after complaint from ostomy association – The Washington Post
- Health Labels for Cigarettes and Little Cigars – Health Canada
- Graphic Canadian Cigarette Warning Labels and Adverse Outcomes: Evidence from Canadian Smokers – WHO
- Graphic Warning Labels Elicit Affective and Thoughtful Responses from Smokers: Results of a Randomized Clinical Trial
Evans AT, Peters E, Strasser AA, Emery LF, Sheerin KM, et al. (2015) Graphic Warning Labels Elicit Affective and Thoughtful Responses from Smokers: Results of a Randomized Clinical Trial. PLOS ONE 10(12): e0142879. https://doi.org/10.1371/journal.pone.0142879 - Brewer NT, Hall MG, Noar SM, et al. Effect of Pictorial Cigarette Pack Warnings on Changes in Smoking Behavior: A Randomized Clinical Trial. JAMA internal medicine. 2016;176(7):905-912. doi:10.1001/jamainternmed.2016.2621.
- Noar SM, Francis DB, Bridges C, Sontag JM, Ribisl KM, Brewer NT. The Impact of Strengthening Cigarette Pack Warnings: Systematic Review of Longitudinal Observational Studies. Social science & medicine (1982). 2016;164:118-129. doi:10.1016/j.socscimed.2016.06.011.
- Our Response & Action to the CDC’s Ostomy Ads – Fight Colorectal Cancer
- Cigarette packs with graphic images, blunt warnings are more effective: focus groups – Toronto Star
By survivor I mean any one having come through illness and an ostomy as a result.
I was bracing myself to respond to you with your exact argument! Lol. So glad we’re not all jumping to being offended straight off. Of course I’d rather not have a bag but I also have no shame in having one either. I may be elegible for reversal (after having colon cancer at age 35 for no apparent diet/lifestyle reason) but if I can’t then I can’t. Smoking does come with consequences for some people and I think this is just being honest! Having an ostomy isn’t easy and could be avoided for people who have choices. For those that don’t have a choice it’s up to us not to be ashamed and continue showing it in a positive light inspite of these truthful pictures.
Personally, I’m not offended. I have a urostomy from a cystectomy due to bladder cancer likely caused by passive smoke. Anything PR to reduce smoking is fine by me. I’ve got a stomach…I LIVE with it.
Hi Linda, your post again says my problem with this Ad, it offends my fellow ostomate. we live in a new age where we are trying to respect colour, sexuality, religious believe and disability!! and rightly so. an ostomate is a person who is a survivor of illness and to be used like this will only serve to hinder being seen as a whole person again. You cannot take part of society and use it to highlight a problem no matter how serious.
John, correct me if I am wrong.. but I don’t see “survivor" in the ad. You don’t have to be a smoker to be as lucky as us to have a front butt. :-)…….. no one understands but us what we and are going through-that is where the respect is here on the blog. We all have options, and fairly accepted. yes. But I think they went over board to us as we are survivors……… (Most of us stopped smoking and that is a hard thig to do, and that is a climb within it self. I congradulate all who succeded. Those that never smoked don’t know this climb.. I quit and I am proud of this step. (never did so many zig- saw puzzles in my life) but I did it!! ) I don’t mind to say I have a pouch, and let others look at me and think wow she is great!! And of course, we get the poor thing look. But I am NOT going to show and tell a smoker your going to get this if u don’t stop. They have it all in there hands to google if they want to. Best to you my friend.
Wow, I was immediately upset by this add. But I think that what got to me was the years that I have suffered from Inflammatory Bowel Disease. It minimized the years of the pain, the out of pocket medications, the appointments, the lack of proper testing, and information and so forth. Then the lack of support hit me. I was stunned by the fact that something, that has been a very beautiful thing for me was somewhat compared to carrying a “TOILET" around all the time. A toilet…wow, that was low. We all know that toilets can be offensive. They can stink and stink is made IN them and that alone can be offensive. We have all had it complained about by our siblings. My father was a smoker. Having a wife and daughter with asthma most likely helped in his decision to quit smoking. I know we all hassled him to quit. I remember him coughing a fair deal. He eventually quit when I was about 14, he had been smoking since grade school. Several years back, it was said his lungs are so clean you would never know he was a heavy smoker. That was over 40 years ago. About seven years ago he called me and began asking questions about my pouch system and how I felt about it. This was not like my father at all. It was also probably the first, really open talk we ever had about Ostomy life. I new immediately what was going on. He had been diagnosed with colorectal cancer. He was terrified. Having a wife and daughter with severe Asthma most likely helped in his decision to quit. On more than one occasion he was rushing one of us, mostly Mom. to emerge. As I am writing this, there is a show on TV called the antiques road show, pre-recorded. There is a poster up with two cowboys, one is bending down to a sitting position, the other leaning down, both with cowboy boots and spurs on and the one standing bends to very politely light the “cigarette" for the other. The bottom of the add says “Patronize Your Home-Town Merchant…He’s Your Neighbor". The add is for Levi Jeans. Worth 1400.00 to 2000.00 dollars. We have been battling adds our whole life. It is all a kind of pressure placed to make decisions to purchase something. To be social. Before I had not seen the rest of the add, I truly thought it was for the cigarettes. It is all very deceiving. My Dad smoked because being a farm boy, it was something everybody did. I have seen the blue noses of uncles who were alcoholics, the yellow skin of liver failure, heard the gasps and sputters of a dieing smoker. It is not pretty at all. It was however a choice made from the start. It annoys me to no end that something like Inflammatory Bowel Disease was minimized to the comparison of carrying around a ‘TOILET" for the rest of my life. Like we store it up all day and it is that easy. I feel for the models in the pictures in these nasty adds. But, they too made a choice. Now they want to share the positive side of having an Ostomy. It’s all good now! Why, because it saved their life and they no longer have to deal with the pain and fear of cancer and possibly dieing any time soon. They now know their families will be okay. They know they will be okay regardless to the choice they made. Part of me gets this and the other part says, yes, it is over for them, good for them. They are so brave. Sure they may have a problem here and there throughout their lives, but will they have the issues that people with Inflammatory Bowel Disease and Birth Defects deal with every single day for the rest of their lives. Progressive disease, and extra-Intestinal Manifestational health issues. They likely will not have to deal with that and, lets talk pain. There has not been a day in my life since I was TEN YEARS OLD that I have not dealt with pain, diarrhea, constipation, and more pain, and nausea and more pain. So much so that I thought it was normal. I really was not upset about the pictures except for the fact that a great lot of us are trying to keep some weight on or to gain it. We deal with so much, on a daily basis, we have been called brave, strong, as my sister said…"hard to kill", not that she was trying to kill me, as it was, it was the disease that was trying so hard. I found it offensive that the pouch was compared to the “carrying a toilet around all day", a TOILET! What is it with that? That was what got to me. It says that we stink, have stains, and have odor and germs which can be publicly offensive. Have big pockets of you know what hanging off our sides. Most of us know what a full baby diaper can smell like. I personally do not carry my output around all day long. I am in the bathroom on average every forty minuets. It is exhausting keeping up with the fluids, the dietary needs for survival, and the amount of hand washing is enough to get labeled a germafobe. Keeping up with prescriptions, and always making sure we have enough equipment for our new reality. Most of us still deal with problems associated to Inflammatory Bowel Disease, daily pain, and the issues that gave us our Ostomy? This is not something we chose, it chose us. Smokers make a choice from before the first cigarette. I know my father did. My Aunts, Uncles and Cousins. None of us kids smoked, not on purpose…it was second hand. Once Dad quit, my asthma, and my mothers, eventually went mostly away. For the smokers, they decided to take that first cigarette and for what ever reason, peer pressure, a bad choice…continued smoking. Once the cancer of a related kind is diagnosed, they will say I should have quit. So, the Government, dealing with the ginormous medical costs is trying still to make smokers and potential smokers make a different decision. So they do this with health issues. Our health is to be so important to us that we never start smoking in the first place. You know well the list of topics they have used to discourage smokers. The point is, it has not worked. So, now, in order to try again they need to make it seem even more offensive then death alone. so it is compared to a toilet. A social stigma. So, they choose an Ileostomy, which seems a little off to me as it should be the Colostomy. Sure they can flip the print or what have you, but they got it mostly wrong again. Now, we are even carrying a toilet around. I have a suggestion for government…the one thing most people like the most is their money. Why not raise that cost, as suggested, for cigarettes, and then put such a tax on it called the MEDICAL TAX and charge for the future bills and costs of trying to heal those who have cancer from cigarettes. Treat it like a death bank account. Once it is proven that their cancer is related to smoking, then use that money to pay for their treatment and surgeries and tests, hospital time, nursing care and equipment needed for their Ostomy. Their after care, and every single thing that is related to their cancer. Once it became knowledgeable that cancer is related to smoking, the government must have realized the medical costs would be immense, yet they have not done anything prominent about it yet. Using an Ostomy to try and scare smokers off is somewhat insulting to those of us who have suffered so long with such undesirable symptoms we would not wish them on an annoying, barking, sleep stealing noisey neighbors dog. Perhaps putting a medical tax on the upfront costs of buying cigarettes, to pay for the future medical care and treatment would be the deterrent. Just the cost of the first pack of cigarettes alone would throw them off key. They most likely would not buy them in the first place, and they certainly would not be able to “lend" them either. I have seen first hand the effects of smoking related disease to humans and it is awful. It is hard to believe that this is cause by something as small as a cigarettes or cigar or a pipe…or….I know there is more but I am tired. Think of the affect it has on family and the ones left behind after a death. What about how they heal from what they have seen and heard. It hurts more then just the smoker. Now we are also, in Canada, dealing with the awful possible affects pot being legalized soon. Pot has smoke also. Just because it is used for fun and to relax by many does not make it any less lethal. The fact that it can be used for medical purposes is wonderful. Wake up Government, it is way past time to do something about this issue and keep the smoke where it belongs…to fires. Not the smoldering smudge and the end of a rolled up piece of tobacco and paper. Do your children a favor, so they do not have to make amends for bad choices of others when they are adults and paying taxes. I do not think using an Ostomy Pouch to teach anti-smoking is the way to go. It ma scare some and gross others but, but really, this is what we with inflammatory Bowel Disease live with, it is not a choice of ours.