The Food and Drug Administration (FDA) on Thursday proposed graphic warning labels that would appear on cigarette packs with ominous messages about the health risks associated with smoking.
The 13 images, if approved, would represent the most significant changes to cigarette labels in 35 years, according to the FDA.
One warning label features a photo of a woman with a large lump on her neck next to text that reads “WARNING: Smoking causes head and neck cancer.”
{mosads}Another image shows a pair of feet with missing toes, with the message “WARNING: Smoking reduces blood flow to the limbs, which can require amputation.”
“Given the extreme risks cigarette smoking poses to the public health, new proposed warnings of this type are critical to promote greater understanding of the risks associated with cigarette smoking,” said Mitch Zeller, director of the FDA’s Center for Tobacco Products.
The proposed images would cover half of the fronts and backs of cigarette packages and must also cover at least 20 percent of cigarette advertisements.
The FDA first issued graphic warning labels in 2011, after being directed to by Congress in 2009, but they were blocked in court after five tobacco companies sued, arguing it violated their First Amendment rights.
The FDA said it would issue new regulations and create new labels, but was sued in 2016 by health groups who argued the agency wasn’t moving quickly enough to comply with the law.
Legal challenges by tobacco companies could further delay the warning labels, which are supposed to appear on cigarette packs by the summer of 2021.
A spokesperson for R.J. Reynolds Tobacco Company, which sued the FDA over its graphic warnings in 2011, said it is “carefully reviewing” the latest proposal.
“We firmly support public awareness of the harms of smoking cigarettes, but the manner in which those messages are delivered to the public cannot run afoul of the First Amendment protections that apply to all speakers, including cigarette manufacturers,” the spokesperson said.
Anti-smoking advocates noted that tobacco companies have a long history of suing to block regulations that could adversely impact the industry.
“Anytime the Food and Drug Administration does something effective that will reduce tobacco use, the tobacco industry will sue,” said Erika Sward, assistant vice president of national advocacy for the American Lung Association.
Research shows the current warnings that appear on cigarette packs — small texts with no graphics that detail the risks of smoking — have become “virtually invisible” to consumers.
The proposed graphic warnings are intended to be more noticeable, easier to understand and easier to remember, the FDA said.
While cigarette smoking rates have declined in the U.S. over the past several decades, more than 34 million adults still smoke.
“The U.S. is falling behind the world when it comes to graphic warning labels, and frankly in other areas to reduce tobacco use,” Sward said.
“With these kinds of hard-hitting graphic warning labels, we will be catching up with what has been effective around the world in dozens of other countries.”