Would you buy a car that looked like this?

Andrew Simms argues that SUVs are as dangerous to health as tobacco and should be made to carry simi

They clog the streets and litter the pages of weekend colour supplements. Sport utility vehicles or SUVs, otherwise known as 4x4s, four-wheel drives and all-terrain wagons, have become badges of middle-class aspiration. They are also dangerous, fabulously polluting and, as part of a general transport problem, set to become, according to the World Health Organisation, one of the world's most common causes of death and disability - ahead of TB, HIV and war. But as the advert for the original British urban crossover car, the Range Rover, puts it, the SUV stands "above it all". It's a place to go, say the advertisers, to "preserve your inner calm".

With the Kyoto Protocol about to kick in and a major conference on global warming starting in Buenos Aires in two weeks, it is time for some fresh thinking on SUVs. In London, Mayor Ken Livingstone has proposed a surcharge on vehicle excise duty for SUVs and a higher congestion charge. But drivers will probably just complain and pay. It's a problem that needs a more creative solution.

The gap between image and reality with SUVs is reminiscent of that in tobacco industry advertising. After all, the scientific consensus over the causes and consequences of climate change closely mirrors that about smoking and cancer. And in the same way as the tobacco advertisers, car advertisers have tried to associate their product with masculinity, health and the outdoor life. So shouldn't SUVs now be labelled in the same way as cigarette packets, with messages such as those in our illustration or "Climate change can seriously damage your health"? This might not entirely stop people driving SUVs, but it would force them to accept the consequences. The case for regulation of this sort is growing like a giant cloud of vehicle exhaust.

According to a 2004 World Health Organisation report, 1.2 million people across the world are killed in road crashes each year and 50 million injured. If nothing changes, the numbers are projected to rise by 65 per cent in 20 years. In Britain alone, there were 290,607 reported road casualties in 2003, including 3,508 deaths.

The WHO compares the global burden of diseases by look- ing at the years of potential life lost as a result of premature death and the years of productive life lost due to disability. In 1990, road traffic accidents ranked ninth on these criteria. By 2020, they will be third. And this does not include the contribution of vehicle emissions to respiratory disease and deaths or to the injuries caused by climate change.

SUVs, by almost any measurements, are more dangerous than other passenger cars. The Ford Explorer, America's biggest-selling SUV, is 16 times more likely than the typical family car to kill the occupants of another car in a crash. Pedestrians, too, are more at risk. You're twice as likely to be killed if you get hit by a 4x4. Even the widespread belief that, come the crunch, so to speak, the SUV owner is better off is a myth. New US federal traffic data reported in the New York Times shows that "people driving or riding in a sport utility vehicle in 2003 were nearly 11 per cent more likely to die in an accident than people in cars". One of the SUV's key selling points, its height, which is meant to make you feel safer, makes these cars twice as likely to be caught in fatal "rollover" accidents as ordinary cars. The US Consumers Union also reports that SUVs suffer from greater rear-view blind spots - which may account for the rise of more than 50 per cent (to 91) last year in the number of US parents who killed their children by reversing over them.

Then there are vehicle emissions. Road transport now accounts for half of most pollutant emissions and a fifth of all CO2 emissions in Europe. In 2002, greenhouse gas emissions from transport in the UK were 47 per cent higher than in 1990.

There are both direct and indirect health consequences. Living in Glasgow, Britain's third most polluted city, has the same effect on the lungs as smoking 44 cigarettes a day, reports the Scotsman. One ingredient of vehicle emissions, particulates, is linked to increased risks of asthma, heart attacks and reduced lung function. The National Asthma Campaign has estimated that asthma, aggravated by air pollution, costs the UK more than £1bn a year. The Department of Health estimated that the deaths of between 12,000 and 24,000 vulnerable people were accelerated by air pollution. Still more casualties can be attributed to climate change. Though the effects are only just beginning, the WHO estimated that it caused 150,000 deaths in 2002.

SUVs are bound to be more dangerous in these respects. They give only around 20 miles a gallon, while the most efficient passenger cars can give three or four times as much.

As the Health Secretary, John Reid, put it the other day: "In a free society, men and women ultimately have the right within the law to choose their own lifestyle, even when it may damage their own health." But, he added, "people do not have the right to damage the health of others, or to impose an intolerable degree of nuisance on others". And when it comes to choosing cars, it seems that neither industry nor the self-absorbed consumer can be trusted to do the right thing.

In the US, by the end of the 20th century, overall vehicle economy had dropped to its lowest level in 20 years. According to the Union of Concerned Scientists, "two decades of fuel-saving technologies, that could have helped curb carbon dioxide emissions, have instead gone into increasing vehicle weight and performance". The figures bear them out. In 1985, SUVs accounted for only one in 50 vehicles sold in the US. Now they make up one in four. In Britain, sales of 4x4s rose 13 per cent in 2003 to 111,846; in London, they now account for one in seven new cars sold.

In the US, people don't drive them just because they like them. Amazingly, the US government waves them on with tax breaks. Even the most costly SUVs - owned by lawyers, real estate agents, plastic surgeons, film stars and so on - get breaks that can be worth up to $35,000. This is because SUVs are modelled on the frames of commercial vehicles. In other words, as far as the US taxman is concerned, they're really trucks. A sales tax credit designed for light trucks of more than 6,000lb ended up being applied to the full range of big cars. This encourages manufacturers to build larger, weightier and more polluting vehicles. Adding transport insult to climate injury, such vehicles are also exempted from emissions limits imposed on US manufacturers.

None of this is a problem if you listen to the industry. "CO2 is not a pollutant. Repeat, not a pollutant," says the SUV Owners of America, an industry front group run by a PR firm that has worked for General Motors, DaimlerChrysler and Ford. "It is a naturally occurring part of the air we breathe." Carbon dioxide is "not" a pollutant only in the way that arsenic is "not" a poison. It's all a question of dosage. And that's the problem with SUVs.

So would fuel taxes change behaviour? Yes, in part. But fuel duties have been politically out of favour since the country was held to ransom during the fuel blockades. And to change behaviour significantly, the taxes have to be very high.

That is why we should look at labelling. If you peer at the small print on car adverts, you can find out how many grams of carbon dioxide per kilometre a car will produce. But that's meaning- less without comparative figures. The government plans to pilot a new labelling scheme based on the green-to-red, A-to-G European labels that are found on electrical appliances.

Research and experience suggest, however, that more is needed. The Society of Motor Manufacturers says that "environmental factors are very low on people's list of priorities when it comes to buying a car". So the New Economics Foundation is looking at the model of tobacco labelling as a way to help people kick the SUV habit. Canadian government research, backed by World Bank findings, shows that there is a direct relationship between the size of warnings and the effect on personal behaviour. "The larger the health warning message," reports Health Canada, "the more effective it is at encouraging smokers to stop smoking."

Where cigarette smoke contains benzene, nitrosamines, formaldehyde and hydrogen cyanide, as the warnings tell us, car exhaust has benzene, particulates, nitrogen oxides and carbon monoxide. Smoking kills, but so do SUVs, their exhaust and the global warming to which they disproportionately contribute.

Opinion is already turning against the vehicles. It is not only London's Ken Livingstone who wants to restrict them. Paris city council has declared that SUVs are "totally unacceptable". In Rome, the city government has proposed to treble the permit rate for SUV owners to enter the city centre. So labelling is the logical next step. The only issue would be classifying the guilty parties. The urban off-roader, crossover SUV, Chelsea tractor, four-wheel drive or 4x4 is instantly recognisable with or without the bullbars. The group encompasses vehicles with similar size and style that are marketed as sport utility vehicles but which may not incorporate substantial off-road features. Styling aside, a threshold could be set to trigger the labelling, such as having a certain number of typical features, on the basis that "if it walks like a duck and talks like a duck . . . ".

Fuel efficiency, already used as a basis for assessing vehicle excise duty, could also be key, with the labelling kicking in when efficiency drops below a certain threshold. Like those for cigarettes, the warnings could cover 30-50 per cent of the vehicles' surface area. People could still drive them, but when they did, they would publicly accept the consequences of their actions, and help the education drive on traffic safety and global warming.

At the least, cigarette-style car labelling would help the industry move out of denial. A recent advert for the Chrysler Crossfire invited the reader to "kiss the sky" with the car. But in an age of global warming, a more honest slogan for a 23mpg vehicle would have been "rip it apart". Label up, and let's go.

Andrew Simms is policy director of nef (the New Economics Foundation), www.neweconomics.org