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Updated tobacco warnings could feature graphic images

The proposed new warnings, three examples of which are pictured above, will cover half of the front and back of each cigarette pack.
The proposed new warnings, three examples of which are pictured above, will cover half of the front and back of each cigarette pack.

The R.J. Reynolds Tobacco Co., which is suing the federal government over tobacco regulation, said it was reviewing the proposed warnings.

"It is worth noting that the legality of requiring larger and graphic warnings is part of our lawsuit that is currently pending," said David Howard, an R.J. Reynolds spokesman.

But Philip Morris USA, which has supported FDA regulation, said the company "has actively participated in the FDA's rule-making and public comment processes and plans to do the same on this proposal."

At least 30 other countries already require graphic warnings, including some, like those in Brazil, that often go even further than the proposed U.S. messages. Canada, which became the first country to require more-graphic warnings in 2000, has seen a significant drop in smoking.

"It's always difficult to point to a particular policy and say it's due to that," said David Hammond, a researcher at the University of Waterloo in Ontario who worked with the advertising agency that developed the proposed warnings for the FDA. "But all the evidence does point to the fact that these things do help."

Some studies, however, have found that some strong warnings may, paradoxically, encourage smoking. But most experts said research indicates that more-graphic images can help reduce cigarette use.

"The bottom line is that there's no magic bullet," Hammond said. "But about one-third of smokers say this increases their motivation to quit, and about the same proportion of former smokers say they remind them why they quit."

Hammond and others warned, however, that within a year or two smokers could become inured to the images, which will make it crucial that they be changed to remain effective.

"It is important that FDA keep the warnings as fresh as possible so that they don't lose impact over time," said David A. Kessler of the University of California at San Francisco, who tried to regulate tobacco when he was FDA commissioner and a flood of revelations emerged about the industry.

Hamburg said the warnings will be updated as needed.

The warnings are part of a broad new federal anti-smoking strategy, officials said. The FDA has already restricted the use of the terms "light," "low" and "mild"; banned the use of fruit, candy and spice flavorings; and is considering taking action against menthol cigarettes.

The federal health-care overhaul provided free access to anti-smoking therapies, and the stimulus package spent $225 million to support local, state and national anti-smoking efforts, officials said. Other measures have been taken to stop the illegal sale of tobacco products over the Internet and through mail order, including illegal sales to youth.

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