RICHMOND, Va. — Rotting teeth and gums. Diseased lungs. The sewn-up corpse of a smoker. Cigarette smoke coming out of the tracheotomy hole in a man's neck.
Cigarette packs in the United States will have to carry these macabre images on 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 on Tuesday, represent the biggest change in cigarette packs in the United States 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's warnings to curb tobacco use, which is responsible for about 443,000 deaths a year in the United States.
The FDA estimates that 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 do 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."
Rhonda Vanover, 43, of Cincinnati, on the other hand, said: "No one is going to stop me, unless they make it illegal. Cigarettes get me through the day. They are part of my life."
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.
The United States first mandated the use of warning labels, saying "Cigarettes may be hazardous to your health," in 1965. The current warning labels — put on cigarette packs in the mid 1980s — say more explicitly that smoking can cause lung cancer, heart disease and other illnesses. But the warnings contain no pictures.