If all goes as planned, smokers buying cigarettes in the fall of 2012 will see some graphic images on the packaging.
There might be a picture of a man with a hole in his throat that has smoke emitting from it. Or an individual that has an ugly cut with staples on their chest. Or a picture showing a comparison of healthy lungs versus smokers' lungs.
The Federal Food and Drug Administration (FDA) has unveiled nine new warning labels containing graphic photos to be placed on cigarette packs. The packages will also include the phone number 1-880-QUIT-NOW.
The images are similar to images already displayed on tobacco containers in other countries.
In the United Kingdom, images depict rotted teeth, open heart surgery, and impotence.
Brazil's cigarette packages have labels of dead fetuses, feet that are infected with gangrene, and hemorrhaging brains.
Uruguay has some of the strongest labels. The government requires that 80 percent of the front and back of all packages be devoted to warnings, including vile photos.
There's a proposal in the parliament of Iceland which would ban the sale of cigarettes and make them a prescription-only product.
"We're the 40th country to adopt this," said Dr. Rosalee Rehrig of West Penn Township of the photos planned for cigarette packs in the U.S. "Thirty-nine other countries are doing this before we decided this is the thing we should do. I hope it deters new people from smoking and maybe some smokers will tone it down."
Rehrig thinks the visual packaging might have more of an impact than the current warning labels, consisting of a bordered message that cigarette smoking is harmful to your health.
One other effect, she pointed out, is that children of smokers might see the photos and say, "Daddy, it will kill you."
Dr. Rehrig said she sees many patients who have complications from smoking, including some with lung cancer and other lung diseases, vascular disease, and erectile dysfunction. She has noticed that many smokers heal slower from medical situations than non-smokers.
"I think this is a step in the right direction," she said.
Cigarette taxes have made an impact, and she would like to them imposed on all tobacco products. Currently chewing tobacco is exempt from many of the taxes imposed on cigarettes.
A volunteer on the board of the Carbon-Tamaqua Unit of the American Cancer Society, Dr. Rehrig helps organize a Relay-for-Life team which, in its fourth year, has raised $10,000 to date.
There will also be a yard sale to benefit ACS at Dr. Rehrig's office beginning at 8 a.m. on Sept. 3 and 4.
Note all United Kingdom residents are convinced that tobacco labels are the most effective deterrent to smoking.
"I think one of the biggest deterants of smoking is the fact we can't smoke in public places; i.e. bars restraunts and stuff," said Nicole Morrison of Scotland. "The pictures have an effect by making you think and work as a scare tactict. I'd say they probably have detered some smokers as it highlights the impact it can have on your health and others. I don't know if you get this in America but here we also get shown a smoker's black lung in primary school to prevent you starting smoking."
Ross Hughes, who lives near Edinburgh, Scotland, said warning pictures have been on tobacco products since about 2008.
"Prior to this I think we only had the health warning statements," he said. "I think that over this time the pictures may have had some impact in helping to dissuade people from taking up smoking and they will also have helped those wishing to quit by providing them with a constant reminder of the dangers. However, as a smoker I personally feel that their impact is limited."
Hughes said his feelings are based on the fact that the pictures only help to reinforce what is quite common knowledge and therefore their placement on the actual product seems a little unnecessary.
"I would also argue that the warnings have less of an impact on younger people as they tend to view the world with an invulnerable naivety that allows them to see the warning and refuse to accept that it could happen to them," he said. "I am happy to accept the argument for the warnings and do not mind them being on my tobacco packet, however I reserve the right to be skeptical as to their effectiveness. I advocate continuing education to the health problems associated with smoking but feel that actions such as those that are taking place in Australia (where branding is set to be removed from the packaging altogether) is going too far."
"If people wish to smoke, particularly in a country where the individual pays for their own healthcare, I think that they should be allowed the right to do so without constant nannying by the state, he added.
Simon McLaughlin of Biggar, Scotland said the warnings may deter younger smokers but he's seen some people laughing at them.
"Most smokers are well educated in how it can damage the body. These pictures only serve as a constant depressing reminder," he said. "On the whole I'd say they only serve to deter easily influenced people."
Mark Horgan of Scotland also downplays the effectiveness of the graphic scenes.
"People know the risks and seeing the pictures just makes me think 'that's a bit gross,' but I still buy the next pack," he said.