RICHMOND, Va. (AP) — Rotting teeth and gums. Diseased lungs. A sewn-up corpse of a smoker. Cigarette smoke coming out of the tracheotomy hole in a man's neck.
Cigarette packs in the U.S. will have to carry these macabre images in nine new warning labels that are part of a campaign by the Food and Drug Administration to use fear and disgust to discourage Americans from lighting up.
The labels, announced Tuesday, represent the biggest change in cigarette packs in the U.S. in 25 years.
At a time when the drop in the nation's smoking rate has come to a standstill, the government is hoping the in-your-face labels will go further than the current surgeon general warnings toward curbing tobacco use, which is responsible for about 443,000 deaths a year in the U.S.
"These labels are frank, honest and powerful depictions of the health risks of smoking," Health and Human Services Secretary Kathleen Sebelius said in a statement.
The FDA estimates the labels will cut the number of smokers by 213,000 in 2013, with smaller additional reductions through 2031.
Other countries such as Canada and Uruguay have used graphic, even grisly, warnings for years, and various studies suggest they spur people to quit. But exactly how effective they are is a matter of debate, since the warnings are usually accompanied by other government efforts to stamp out smoking.
"I think it's a great deterrent for kids," said Kristen Polland, 24, of Prattville, Ala. "If you start there, you have won half of the battle."
The labels also include images of a smoker wearing an oxygen mask and a mother and baby with smoke swirling nearby. Some images are not graphic at all; one shows a man wearing an "I Quit" T-shirt.
The warnings will take up the entire top half — both front and back — of a pack of cigarettes. They must also appear in advertisements and constitute 20 percent of each ad. Cigarette makers will have to run all nine labels on a rotating basis. They have until the fall of 2012 to comply.
The legality of the new labels is already being challenged in a federal lawsuit bought by some of the major tobacco companies, which argue that the warnings will relegate the brand name to the bottom half of the cigarette package, making it difficult or impossible to see.
A pack-a-day smoker would see the graphic warnings more than 7,000 times per year.