SourceCorpses, cancer patients and diseased lungs are among the images the federal government plans for larger, graphic warning labels that would take up half of each pack of cigarettes sold in the United States.
Whether smokers addicted to nicotine will see them as a reason to quit remains a question.
The images are part of a new campaign announced by the Food and Drug Administration and the Department of Health and Human Services on Wednesday to reduce tobacco use, which is responsible for about 443,000 deaths per year.
"Some very explicit, almost gruesome pictures may be necessary," FDA Commissioner Margaret Hamburg said in an interview with The Associated Press. "This is a very, very serious public health issue, with very, very serious medical consequences," such as cancer, heart disease, strokes and lung diseases.
The share of Americans who smoke has fallen dramatically since 1970, from nearly 40 percent to about 20 percent, but the rate has stalled since about 2004. About 46 million adults in the U.S. smoke cigarettes.
In the same period, the average cost per pack has gone from 38 cents to $5.33. Much of those increases are from state and federal taxes.
The new prevention plan is part of a law passed in June 2009 that gave the FDA 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 FDA is proposing 36 labels for public comment. They include phrases like "Smoking can kill you" and "Cigarettes cause cancer" and feature graphic images to convey the dangers of tobacco.
"It acts as a very public billboard because you all of the sudden are reading something about lung cancer from that pack behind the cash register, whereas before you were just reading 'Marlboro,'" said David Hammond, a health behavior researcher at the University of Waterloo in Canada, who is working with the firm designing the labels for the FDA.
Some of the labels include a man with a tracheotomy smoking a cigarette, a cartoon of a mother blowing smoke in her baby's face, rotting and diseased teeth and gums, as well as cigarettes being flushed down the toilet to signify quitting.
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