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The Food and Drug Administration has unveiled its proposals for new warning labels on all cigarette packaging and ads. The labels are bold and scary, a contrast to the more subtle warnings that have been on the side of cigarette packs for 25 years.

Here's NPR's Richard Knox.

RICHARD KNOX: The new warnings are graphic. One shows a corpse with a toe tag. There's the wasted face of a cancer patient, a man having a heart attack, a pair of lungs blackened by cigarette tar.

FDA Commissioner Margaret Hamburg says these are powerful images.

Ms. MARGARET HAMBURG (Commissioner, Food and Drug Administration): That, after all, is the point. We need to make sure that anyone who's considering smoking fully appreciates the consequences of cigarette use. That means presenting the facts directly and bluntly.

KNOX: Hamburg says tobacco makers will have until September of 2012 to make the change. The new warnings must take up the top half of all cigarette packs, front and back, and the top 20 percent of all ads.

Ms. HAMBURG: Once that happens, every single pack of cigarettes in our country will, in effect, become a mini-billboard that tells the truth about smoking.

KNOX: The government hopes that will persuade the 47 million Americans who now smoke to quit and discourage teenagers from starting. But how much impact will that really have? To get an idea, I went to the Codman Square Health Center in Boston. Lisdoris Marie Cruze is waiting to see the pediatrician.

Ms. LISDORIS MARIE CRUZE: I'm 19.

KNOX: And you have children?

Ms. CRUZE: I have twin boys, and they're a year and a half.

KNOX: Cruze is a smoker. She started when she was 16. She agrees to look at some of the proposed warning labels.

Ms. CRUZE: Warning: Cigarettes cause cancer. I already knew that.

KNOX: In fact, her brother died of lung cancer at the age of 28. Most of the other images also leave her unfazed. Then she comes to this one.

Ms. CRUZE: Oh my God, this is so gross.

KNOX: It's two pairs of lungs: on the left, healthy pink ones; on the right, lungs ravaged by smoking.

Ms. CRUZE: Wow, I never seen something like that, so very new to me, you know?

KNOX: So that could be what your lungs look like in a while?

Ms. CRUZE: Yeah, that could. That could look like me. My lungs, oh my gosh.

KNOX: Seeing that on her pack of cigarettes might make a difference.

Ms. CRUZE: That's going to make me want to stop. You know, it's going to make me go on my patches and, you know, and just try to do it for myself and for my kids because I know my kids are going to need me, you know.

KNOX: But she's tried to quit before. And like most quitters, it didn't stick. That gets to the heart of the problem. Canada has had graphic health warnings on cigarette packages for a decade. David Sweanor of the University of Ottawa says they do work.

Mr. DAVID SWEANOR (University of Ottawa): What we see with these sorts of warnings is that it does increase motivation. Now, people are more aware of the risks. They are wanting to quit. But that has to be combined with services that make it more likely.

KNOX: Sweanor says smoking hasn't gone down as much in Canada as they'd hoped because the government hasn't provided enough access to smoking cessation programs. The U.S. government's new campaign does include more coverage of quit-smoking programs through Medicare, Medicaid and private insurance, but some wonder if the funding will materialize.

Tobacco makers didn't comment today on the proposed labels. But one has already sued to block them on grounds of free speech.

Richard Knox, NPR News.

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