US makes new push for graphic warning labels on cigarettes

WASHINGTON (AP) — U.S. health officials are making a new attempt at adding graphic images to cigarette packets to discourage Americans from lighting up. If successful, it would be the first change to U.S. cigarette warnings in 35 years.

The Food and Drug Administration on Thursday proposed 13 new warnings that would appear on all cigarettes, including images of cancerous neck tumors, diseased lungs and feet with amputated toes.

Other color illustrations would warn smokers that cigarettes can cause heart disease, impotence and diabetes. The labels would take up half of the front of cigarette packages and include text warnings, such as "Smoking causes head and neck cancer." The labels would also appear on tobacco advertisements.

SEE ALSO: 22 people have been hospitalized with vaping-linked breathing problems. Doctors don't know why.

The current smaller text warnings on the side of U.S. cigarette packs have not been updated since 1984. They warn that smoking can cause lung cancer, heart disease and other illnesses. These warnings "go unnoticed" and are effectively "invisible," the FDA said it its announcement.

The FDA's previous attempt was defeated in court in 2012 on free speech grounds. A panel of judges later upheld the decision, siding with tobacco companies that the agency couldn't force cigarettes to carry grisly images, including cadavers, diseased lungs and cancerous mouth sores.

FDA's tobacco director Mitch Zeller said the new effort is supported by research documenting how the warnings will educate the public about lesser-known smoking harms, such as bladder cancer.

"While the public generally understands that cigarette smoking is dangerous, there are significant gaps in their understanding of all of the diseases and conditions associated with smoking," said Zeller. If the agency is sued, he added, "we strongly believe this will hold up under any legal challenges."

19 PHOTOS
E-cigarettes and vaping
See Gallery
E-cigarettes and vaping

Employee at Cloud 10, an e-cigarette store in Simi Valley, CA, demonstrates the type of smoke, with no smell, comes out of an electric cigarette. Sales are Booming at this store.

(Lynne Gilbert via Getty Images

A customer exhales vapor while smoking an electric cigarette at the Betamorph E-Cigs store in Albuquerque, New Mexico, U.S., on Saturday, Dec. 10, 2016. Sales in the U.S. vapor-device market are projected to rise by 21% annually through 2020, based on Euromonitor Passport data.

(Sergio Flores/Bloomberg via Getty Images)

An e-cigarette store in Simi Valley, CA, called Cloud 10, displays various types of electric cigarettes juice flavors for sale. Sales are Booming at this store.

(Lynne Gilbert via Getty Images)

Indonesian teenager exhaling smoke from Electric Cigarettes (e-cigarettes) as seen in Medan, North Sumatra, Indonesia on December 5, 2014 night. Electric cigarettes (e-cigarettes) are increasingly popular in Indonesia, especially among teenagers. In fact, cigarettes are actually more harmful than regular cigarettes with an increasing number of patients with poisoning after using electronic cigarettes and nicotine liquid continues to increase. The World Health Organization (WHO) notes, electronic cigarette brand has been produced in 466, 8,000 taste, spending budget of US $ 3 billion.

(Photo by Ivan Damanik/NurPhoto) 

Gdynia, Poland 29th, Dec. 2015 Polish Ministry of Health plans to ban electronic cigarettes sales to persons under the age of 18, restrictions on advertising and promotion and to introduce to them technical requirements. The new Tobacco Control law will come into force in the 2nd quarter of 2016. Pictured: Lady smokes electronic cigarette.

(Michal Fludra/Corbis via Getty Images)

Kiradech Aphibarnrat of Thailand smokes an electric cigarette during day two of the World Cup of Golf at Kingston Heath Golf Club on November 25, 2016 in Melbourne, Australia.

(Photo by Quinn Rooney/Getty Images)

Electric cigarette 'juice' w/various flavors.This is at Cloud 10 in Simi Valley, CA This brand is the most popular at this store. Santa Monica just passed the law no e-cigarettes allowed anywhere. Business is booming at this location.

(Lynne Gilbert via Getty Images

Mitchell Baker who works at the Vapour Place a vaping shop in Bedminster, exhales vapour produced by an e-cigarette on December 30, 2016 in Bristol, England. Recent figures released by the e-cigarette industry has claimed that there as many as 1700 vaping shops across the country, with two new ones opening each day catering for the estimated three million vapers in the UK. The popularity of e-cigarettes has boomed in the last ten years, as it is seen by many as a healthier alternative to traditional cigarettes, however some critics say the devices can carry the same risks as smoking especially as the long term affects are yet to be known.

(Matt Cardy/Getty Images)

E-cigarette merchandise is displayed for sale at the Vapour Place a vaping shop in Bedminster, on December 30, 2016 in Bristol, England. Recent figures released by the e-cigarette industry has claimed that there as many as 1700 vaping shops across the country, with two new ones opening each day catering for the estimated three million vapers in the UK. The popularity of e-cigarettes has boomed in the last ten years, as it is seen by many as a healthier alternative to traditional cigarettes, however some critics say the devices can carry the same risks as smoking especially as the long term affects are yet to be known.

(Photo by Matt Cardy/Getty Images)

A reveller dressed in a Father Christmas costume smokes from an electronic cigarette device as he takes part in Santacon outside Euston Station on December 10, 2016 in London, England. Santacon is an annual parade taking place in cities around the world and sees revellers dressed in Father Christmas costumes take to the streets to spread seasonal cheer.

(Photo by Jack Taylor/Getty Images)

Flavored vape juice bottles are displayed for sale at the Betamorph E-Cigs store in Albuquerque, New Mexico, U.S., on Saturday, Dec. 10, 2016. Sales in the U.S. vapor-device market are projected to rise by 21% annually through 2020, based on Euromonitor Passport data.

(Sergio Flores/Bloomberg via Getty Images)

A woman smokes an electronic cigarette during the Vapexpo 2015 Moscow, at Sokolniki Exhibition Center on December 05, 2015, in Moscow, Russia.

(Photo by Sefa Karacan/Anadolu Agency/Getty Images)

This picture taken on November 19, 2015 shows bottles of concentrated flavors displayed at a vape shop in Kuala Lumpur. Vaping' is soaring in popularity in Malaysia, the largest e-cigarette market in the Asia-Pacific region, but authorities are threatening to ban the habit in for health reasons -- a move that has sparked anger from growing legions of aficionados.

(MOHD RASFAN/AFP/Getty Images)

A man smokes an E-Cigarette in the Vape Lab coffee bar, on August 27, 2014 in London, England. The Department of Health have ruled out the outlawing of 'e-cigs' in enclosed spaces in England, despite calls by WHO, The World Health Organisation to do so. WHO have recommended a ban on indoor smoking of e-cigs as part of tougher regulation of products dangerous to children.

(Photo by Dan Kitwood/Getty Images)

This picture taken on November 19, 2015 shows a worker (R) inspecting a coil, the metal heating element in an e-cigarette that produces vapour from e-juices, at a vape shop in Kuala Lumpur. Vaping' is soaring in popularity in Malaysia, the largest e-cigarette market in the Asia-Pacific region, but authorities are threatening to ban the habit in for health reasons -- a move that has sparked anger from growing legions of aficionados.

(MOHD RASFAN/AFP/Getty Images)

A woman smokes an electronic cigarette during the Vapexpo 2015 Moscow, at Sokolniki Exhibition Center on December 05, 2015, in Moscow, Russia.

(Photo by Sefa Karacan/Anadolu Agency/Getty Images)

A customer smokes an E-Cigarette at Digital Ciggz on January 28, 2015 in San Rafael, California. The California Department of Public Health released a report today that calls E-Cigarettes a health threat and suggests that they should be regulated like regular cigarettes and tobacco products.

(Photo by Justin Sullivan/Getty Images)

E-Cigarettes are sold at the V-Revolution E-Cigarette shop in Covent Garden on August 27, 2014 in London, England. The Department of Health have ruled out the outlawing of 'e-cigs' in enclosed spaces in England, despite calls by WHO, The World Health Organisation to do so. WHO have recommended a ban on indoor smoking of e-cigs as part of tougher regulation of products dangerous to children.

(Photo by Dan Kitwood/Getty Images)

In this photo illustration, a man smokes an E-Cigarette at the V-Revolution E-Cigarette shop in Covent Garden on August 27, 2014 in London, England. The Department of Health have ruled out the outlawing of 'e-cigs' in enclosed spaces in England, despite calls by WHO, The World Health Organisation to do so. WHO have recommended a ban on indoor smoking of e-cigs as part of tougher regulation of products dangerous to children.

(Photo by Dan Kitwood/Getty Images)

HIDE CAPTION
SHOW CAPTION
of
SEE ALL
BACK TO SLIDE

Reynolds American, maker of Camel and Newport cigarettes, said it supports public awareness efforts on tobacco, "but the manner in which those messages are delivered to the public cannot run afoul of the First Amendment." Reynolds was one of five tobacco companies that challenged the FDA's original warning labels.

The nation's largest tobacco company, Altria, said it will "carefully review the proposed rule." The company, which makes Marlboro, was not part of the industry lawsuit.

Nearly 120 countries around the world have adopted the larger, graphic warning labels. Studies from those countries suggest the image-based labels publicize smoking risks and encourage smokers to quit.

Current U.S. cigarette labels don't reflect the enormous toll of smoking, said Geoff Fong, who heads the International Tobacco Control Project.

"This is a deadly product," said Fong, who studies anti-tobacco policies at Canada's University of Waterloo. "We have more prominent warnings on many other products that don't pose even a fraction of the risk that cigarettes do."

Canada became the first country to put graphic warnings on cigarettes in 2000.

Smoking causes more than 480,000 deaths each year in the U.S, even though smoking rates have been declining for decades. Approximately 14% of U.S. adults smoke, according to government figures. That's down from the more than 40% of adults who smoked in the mid-1960s.

Under the 2009 law that first gave the FDA oversight of the tobacco industry, Congress ordered the agency to develop graphic warning labels that would cover the top half of cigarette packs. The FDA proposed nine graphic labels, including images of rotting teeth and a smoker wearing an oxygen mask.

But a three-judge panel ruled that the FDA's plan violated companies' right to free speech. The judges said the images were unconstitutional because they were "crafted to evoke a strong emotional response," rather than to educate or warn consumers.

SEE ALSO: College student's lung collapses after smoking Juul pods: 'Like I was having a heart attack'

The FDA said it would develop a new batch of labels, but when new ones didn't appear, eight health groups sued the agency in 2016 for the "unreasonable delay."

Under a court order this year, the FDA was required to propose new labels by August, with final versions by next March.

___

Follow Matthew Perrone on Twitter: @AP_FDAwriter

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.

Read Full Story