Dead bodies, diseased lungs and rotting teeth were among the among the graphic images for revamped U.S. tobacco labels, unveiled Tuesday by health officials who hope the warnings will help smokers quit.
The new labels must be on cigarette packages and tobacco advertisements no later than September 2012, as part of a law that put the multibillion-dollar tobacco industry under the control of the U.S. Food and Drug Administration.
They represent the first change in U.S. cigarette warnings in 25 years.
"With these warnings, every person who picks up a pack of cigarettes is going to know exactly what risks they are taking," Health and Human Services Secretary Kathleen Sebelius told reporters at the White House.
The new labels may disturb some, including one with a photograph of a man smoking a cigarette through a hole in his throat, and one showing a mouth with discolored teeth and an ulcerated lip.
Other images stress the dangers of second-hand smoke to children and show tobacco's causal link to lung disease, cancer, strokes, heart disease and death.
Ms. Sebelius said the goal was to stop children and teenagers from starting to smoke and to give nicotine-addicted adults an added incentive to quit, helping push down U.S. smoking levels that have been stubbornly stagnant in recent years.
"We want kids to understand that smoking is gross not cool and there is really nothing pretty about having mouth cancer or making your baby sick if you smoke," she said.
More than 221,000 Americas will be diagnosed with lung cancer in 2011, accounting for about 14 percent of all U.S. cancer cases, according to the American Cancer Society. Nearly 157,000 men and women are expected to die from lung cancer this year in the United States.
The World Health Organization has repeatedly called for graphic images of diseased organs and heavily stained teeth on tobacco packs as a turn-off. But in Europe and elsewhere, young smokers often buy decorative holders to hide the warning labels on their cigarette packs.
The 2009 Family Smoking Prevention and Tobacco Control Act called for cigarette packages to include warning statements in large type covering half of the front and back of each package and graphic images showing the health dangers of smoking.
The warnings are also to occupy the top 20 percent of every tobacco advertisement of companies such as Altria Group Inc's Philip Morris USA unit, Reynolds American Inc's R.J. Reynolds Tobacco unit and Lorillard Inc's Lorillard Tobacco Co.
The anti-smoking group Campaign for Tobacco-Free Kids said the images were a dramatic change from today's printed warnings that simply list potential health problems from smoking.
"The current warnings are more than 25 years old, go unnoticed on the side of cigarette packs and fail to effectively communicate the serious health risks of smoking," the group said.
Tobacco companies take advertising curbs and health warning rules seriously as possible restrictions on their ability to do business. R.J. Reynolds, for instance, has challenged the legality of mandated larger and graphic warnings in a federal lawsuit.
Elsewhere, Philip Morris International has sued Uruguay over the South American country's anti-smoking rules, which include large health warnings on cigarette packs and a ban on tobacco products branded "light."
The company said that arbitration was meant to challenge "extreme and ineffective measures that have created an environment conducive to the black market in cigarettes."
Ms. Sebelius, estimating that tobacco costs the U.S. economy $200-billion a year in medical costs and lost productivity.
Tobacco will kill nearly 6 million people worldwide this year, including 600,000 non-smokers, the WHO said last month, estimating the global annual death toll could reach 8 million by 2030.
The Dow Jones tobacco index, whose components include Altria, Lorillard and Reynolds American, was down 1 percent on Tuesday afternoon after the images were unveiled.