Vote for your favorite cigarette health warning

Starting Friday, the FDA is seeking public comment online or by fax on which 9 of 36 proposed graphic health warnings to include on cigarette packages.

The U.S. Department of Health and Human Services today unveiled 36 graphic cigarette warning images, 9 of which will make their way to cigarette packages and advertisements in 2012, and they've given the public two months to weigh in, starting Friday.

This is one of 36 proposed graphic health warnings. FDA

Tobacco use is the leading cause of premature and preventable death in the United States, according to the HHS, and it is responsible for 443,000 deaths each year, with 1,200 current and former smokers dying prematurely every day due to tobacco-related diseases.

Dozens of countries around the world, including the U.S., already mandate the presence of some form of health warning on cigarette packages. A smaller number, including Brazil and Australia, require that graphic images take up a certain percentage of those ads and packages; Canada led that pack, so to speak, with images that cover at least half of the entire package since 1994.

The Family Smoking Prevention and Tobacco Control Act, introduced in March 2009 and signed into law by President Barack Obama in June 2009, requires the Food and Drug Administration to issue final regulations requiring these color graphics by June 22, 2011, after a review of "the relevant scientific literature, public comments, and results from an 18,000-person study." The final rule prohibiting companies from manufacturing cigarettes without new graphic health warnings on their packages for sale or distribution in the U.S. will go into effect in September of 2012.

The nine graphic health warnings must appear on the top of the front and rear panels of each cigarette package and take up at least the top 50 percent of these panels.

"Some very explicit, almost gruesome pictures may be necessary," FDA Commissioner Margaret Hamburg told The Associated Press.

Judge for yourself on the FDA's Web site. Images range from a rather gruesome close-up of rotting teeth to a far less messy cartoon of a mother blowing smoke in her baby's face, to a black-and-white rendering of a cigarette package followed by an arrow pointing to a headstone with the letters RIP.

Of course, denial is a strong force. In 2003, The Telegraph reported that sales of cigarette cases in the United Kingdom grew by 300 percent in one year, as people tried to hide stern health warnings on cigarette packages. Another choice alternative was to cover the warnings with stickers such as, "You could be hit by a bus tomorrow" and "Smoking is cool."

If you find the FDA's proposed images too graphic, check out what Brazil's Health Ministry chose:

In 2001 Brazil became the second country in the world to require that warnings and graphic images illustrating the risks of smoking cover some portion of cigarette packages. Instituto Nacional do Cancer
 

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