Coming to a store near you: nine more reasons not to smoke

RICHMOND, Va. Coming to a store near you: nine more reasons not to smoke.In the most significant change to U.S. cigarette packs in 25 years, the Food and Drug Administration on Tuesday is set to release nine new warning labels that will depict in graphic detail the negative health effects of tobacco use. Among the possible images are rotting and diseased teeth and gums and a man with a tracheotomy smoking.

The labels will take up the top half of a pack - both front and back - of cigarette packs. Warning labels also must appear in advertisements and constitute 20 percent of an ad. Cigarette makers have until the fall of 2012 to comply.

Mandates to introduce new graphic warning labels were part of a law passed in 2009 that, for the first time, gave the federal government authority to regulate tobacco, including setting guidelines for marketing and labeling, banning certain products and limiting nicotine. The law doesn't let the FDA ban nicotine or tobacco.

The announcement follows reviews of scientific literature, public comments and results from an FDA-contracted study of 36 labels proposed last November, which included corpses of smokers, cancer patients and diseased lungs.

Some of the labels proposed last year include a mother blowing smoke in her baby's face and cigarettes being flushed down the toilet to signify quitting. They include phrases like "Smoking can kill you" and "Cigarettes cause cancer" and feature graphic images to convey the dangers of tobacco, which is responsible for about 443,000 deaths in the U.S. per year.

Whether the federal government chose to go with more hard-hitting images for the new labels or more subtle messages like illustrations of a smoker being controlled by strings like a marionette remains a question.

In recent years, more than 30 countries or jurisdictions have introduced labels similar to those being introduced by the FDA. The U.S. first mandated the use of warning labels stating "Cigarettes may be hazardous to your health" in 1965. Current warning labels - a small box with black and white text - were put on cigarette packs in the mid-1980s.

"For a product that kills as many people as smoking, what is the right level of a warning? There are people that are going to argue that so long as they're going to sell these things in corner stores, they government has a responsibility to warn people to the full extent possible," David Hammond, a health behavior researcher at the University of Waterloo in Canada, who worked with the firm designing the labels for the FDA.

The new labels come as the share of Americans who smoke has fallen dramatically since 1970, from nearly 40 percent to about 20 percent. The rate has stalled since about 2004. About 46 million adults in the U.S. smoke cigarettes.

It's unclear why declines in smoking have stalled. Some experts have cited tobacco company discount coupons on cigarettes or lack of funding for programs to discourage smoking or to help smokers quit.

While it is impossible to say how many people quit because of the labels, various studies suggest that the labels do spur people to quit. The new labels offer the opportunity for a pack-a-day smoker to see graphic warnings on the dangers of cigarettes more than 7,000 times per year.The World Health Organization said in a survey done in countries with graphic warning labels that a majority of smokers noticed the warnings and more than 25 percent said the warnings led them to consider quitting.

The legality of the new labels also is part of a pending federal lawsuit filed by Winston-Salem, N.C.-based Reynolds American Inc., parent company of America's second-largest cigarette maker, R.J. Reynolds, No. 3 cigarette maker Lorillard Inc. and others.Tobacco makers in the suit have argued the warnings would relegate the companies' brands to the bottom half of the cigarette packaging, making them "difficult, if not impossible, to see."(AP)