This is one of the nine new warning labels smokers will see by the fall of 2012.

This is one of the nine new warning labels smokers will see by the fall of 2012. (AP Photo/U.S. Food and Drug Administration)

For two decades starting in the 1930s, the respected Journal of the American Medical Assn. (JAMA) ran advertisements for cigarettes. A long-running ad (see it and others here) proclaimed that "20,679 Physicians say 'LUCKIES are less irritating.'" All these years later, cigarette packages are  featured in a leading medical journal--the venerable New England Journal of Medicine. But the latest ones show tobacco's toll: dead bodies, blackened lungs and shattered lives.

The journal this week published a slide show for its readers introducing the graphic warning labels that will cover the top half of every package of cigarettes sold in the United States starting in the fall of 2012. The new images and messages, ordered by the FDA in June under new rules giving the agency broad powers to regulate tobacco, were accompanied by a brief "perspective" by Dr. Howard K. Koh, assistant secretary for health, Department of Health and Human Services.

The new graphic warnings, Koh wrote, "are more likely to be noticed than text-only labels, are viewed as more effective in communicating health risks to smokers, and are associated with increased motivation on the part of smokers to quit smoking." Some 30 countries have preceded the U.S. in requiring that cigarette packaging include graphic--sometimes very graphic--labels that warn consumers about the known health consequences of smoking tobacco and exposing others to tobacco smoke. You can see images of graphic warnings used around the world here.

The FDA has said it will likely issue a second crop of graphic warning labels within a year or two after the new labels go into broad circulation, to ensure that consumers continue to notice and respond to the messages. Among those the FDA might adopt is a powerful image that Canada recently announced it will use in its second round of warning labels. You can see the image and read the remarkable back story of it here.

The New England Journal of Medicine's slideshow comes on the heels of anFTC tobacco advertising tally study by the U.S.Federal Trade Commission showing that advertising for tobacco products in the United States totaled $9.94 billion in 2008, the lowest level in a decade.