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Gory cigarette labels are common elsewhere

NEW YORK – While graphic new warning labels on cigarette packs that show a diseased lung or rotting teeth may be shocking to U.S. consumers, those in countries from Egypt to Uruguay may ask: “What’s the big deal?”

The Food and Drug Administration on Tuesday released nine new labels for cigarette packs that aim to show the dangers of smoking through images such as a diseased lung and a smoker wearing an oxygen mask. But more than 40 countries around the world already require warnings as graphic as the new U.S. labels – if not more so.

The U.S. warnings – the biggest change to the labels in 25 years – use mostly fear and disgust to discourage Americans from smoking. The FDA estimates the new labels will cut the number of smokers by 213,000 in 2013, with smaller additional reductions through 2031. While it’s impossible to attribute reduced smoking rates to any single cause, in Canada, Brazil, Thailand and other countries, stronger warnings have been associated with an increase in the number of smokers trying to quit.

“We are so far behind,” says Michael Cummings, chair of the Roswell Park Cancer Institute’s Department of Health Behavior. “We’re a third-world nation when it comes to educating the public on the risks of smoking.”

The new warning labels include images of cigarette smoke coming out of a tracheotomy hole in a man’s neck, a mother and baby with smoke swirling nearby and a sewn-up corpse. They 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.

Before the new labels were introduced, the U.S. had some of the weakest cigarette warnings in the world. The introduction of the graphic labels was required in a 2009 law that, for the first time, gave the federal government authority to regulate tobacco.

The U.S. first mandated the use of warning labels stating, “Cigarettes may be hazardous to your health” in 1965. The current warning labels were put on cigarette packs in the mid-1980s.

Tobacco use annually costs the economy nearly $200 billion in medical costs and lost productivity and contributes to about 443,000 deaths in the U.S.

Uruguay has some of the world’s strongest warning labels. The government requires 80 percent of the front and back of all cigarettes packages be devoted to warnings. One version shows a person smoking a battery like it’s a cigarette to illustrate that both contain the toxic metal cadmium.

In Brazil, labels feature graphic images of dead fetuses, hemorrhaging brains and gangrened feet. They also fill an entire face of a cigarette box. In a survey, 54 percent of Brazilian smokers said these gory warnings had changed their opinion on the health consequences of smoking, while more than two-thirds said the images boosted their desire to quit, according to a report by World Health Organization researchers.