Cigarette packs could be covered with images of a man smoking out of a hole in his neck or a mother blowing cigarette smoke into her child's face, if the tobacco control strategy submitted by the Department of Health and Human Services today (Nov. 10) is approved by the Food and Drug Administration.

The Tobacco Control Act, enacted by Congress in June 2009, gives the FDA until June 22, 2011, to select from the labels proposed today — nine bigger, bolder, color health warnings —  and to mandate they cover at least 50 percent of the front of cigarette packs starting in October 2012.

Under the Federal Cigarette Labeling and Advertising Act of 1965, cigarette manufacturers have been required to put a small label on packs, warning of the health risks of smoking cigarettes. The labels have been unchanged for 25 years, according to the Department of Health and Human Services.

"The last time cigarette warnings were changed, Reagan was in the White House and 'Back to the Future' was the most popular movie in America," said Erika Sward, director of national advocacy at the American Lung Association.

"The current warning labels are ineffective" — no more of a deterrent than having no warning labels at all, she told MyHealthNewsDaily.

The FDA is seeking public comment on the proposed images from Nov. 12 to Jan. 11. [Related: Images of the proposed labels]

Cigarette companies, including the second-largest cigarette manufacturer, Reynolds American Inc., say the requirements are "a violation of commercial free speech and First Amendment rights," according to spokesman David Howard.

Reynolds and other companies filed a lawsuit last year contesting the labels and other aspects of the Tobacco Control Act. The suit is currently pending in federal appeals court.

Do they work?

Other countries, including Thailand, Brazil and the Philippines, have put graphic, smoking-related images on the fronts of cigarette packs. Canada implemented some more than 10 years ago, said Stanton Glantz, a professor of medicine at University of California, San Francisco, and director of the Center for Tobacco Control Research and Education.

"When you put these in, they affect behavior, and the stronger the labels are, the bigger the effect," Glantz told MyHealthNewsDaily. "This is long overdue."

Previous research has shown that more-graphic labeling can help persuade smokers to quit, Glantz said. And a 2007 study published in the journal Health Policy found that U.S. warning-label requirements were weak and largely symbolic in comparison with Canadian warning labels.

Moving the warning onto the front of the cigarette pack, and into the advertising of the cigarette brand, is important in getting people to actually pay attention to it, Glantz said.

Smokers have their say

Not everyone thinks the new labels will be persuasive.

Shannon Armour, 31, has been smoking cigarettes for 17 years. She said the proposed warning labels aren't stirring enough to get people to stop.

"I already know that these are the consequences of what I'm doing, and I already know that it's bad, so I don’t really think it's going to change anything," said Armour, who works as an administrative assistant in Phoenix.

But the labels might deter kids from smoking because they show pictures of the consequences, she said.

Sward, of the American Lung Association, said the labels themselves can't be expected to stop everyone from smoking, but when they are combined with aggressive regulation of tobacco products, smoke-free laws and high tobacco taxes, a demand for quitting will be created.

"What we then need to do is for the federal and state governments to go the next stage, which is to dedicate resources to make sure smokers get the help they need to quit," she said.

Sward said the labels could be improved with the addition of the 1-800-QUIT-NOW phone number, so smokers could more easily find help if they wanted to quit.

This article was provided by MyHealthNewsDaily, a sister site to LiveScience.