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The Food and Drug Administration is proposing new warnings for cigarette packs and ads that would depict the negative health consequences of smoking.

According to a report from Kentucky Health News, "The warnings would be the first update to cigarette package warnings in more than 30 years. A 2009 law authorized them, but a tobacco-company lawsuit blocked FDA's first attempt."

The proposed rule would require the images to be in color, to be honest, and accurate in graphically depicting the potential risks that come with smoking and tobacco use.

Some of the proposed warnings include:

• "Tobacco smoke can harm your children," with an image that shows the head and shoulders of a boy 8 to 10 years old, wearing a hospital gown and receiving a nebulizer treatment for chronic asthma.

• "Smoking causes head and neck cancer," with an image showing the head and neck of a woman 50 to 60 years old who has a tumor protruding from the right side of her neck, just below her jawline.

• "Smoking causes bladder cancer, which can lead to bloody urine," with an image of a gloved hand holding a specimen cup with bloody urine.

• "Smoking during pregnancy stunts fetal growth," with an image of an infant on a medical scale with a digital display reading 4 pounds.

• "Smoking can cause heart disease and strokes by clogging arteries," with an image of a 60- to a 70-year-old man with a large, recently sutured incision in his chest as he undergoes monitoring.

There are at least a half dozen more proposed images that range from risks like erectile dysfunction, amputation, diabetes, macular degeneration and even blindness.

Inside Health Policy's Beth Wang reported, "The proposed warnings are required by law to be displayed on half the front and rear panels of cigarette packages, and on the top 20% of the area at the top of advertisements."

"This marks the second time FDA has issued a proposed rule to require graphic warnings on cigarette labels and advertisements," Wang notes. "The first rule was blocked in 2012 by the U.S. Court of Appeals for the District of Columbia in R.J. Reynolds Tobacco Company v. FDA, which argued the proposed rule violated the First Amendment by not justifying why there is a need to issue regulation on commercial speech. In March, however, a federal court ordered FDA to issue the proposed rule by Aug. 15, and a final rule by March 15, 2020."

While these images can be startling, we think campaigns like this are necessary for the efforts to reduce smoking, especially in Kentucky, where the rates are higher than the national average and cancer deaths attributed to smoking are the highest in the nation.

According to the Kentucky Health Issue Poll reported by the Foundation for a Healthy Kentucky, about 1 in 4 (23 percent) of Kentucky adults smoke cigarettes, higher than the national average of 17 percent. Kentucky has the second-highest rate of smoking in the country -- behind only West Virginia. Clark County's rates are a bit higher than the state with about 29 percent of adults reporting smoking in 2016.

Approximately 9,000 deaths each year in Kentucky are attributable to smoking. Kentucky also has the second-highest rate in the nation of high schoolers who smoke, according to the Coalition for a Smoke Free Tomorrow. In the U.S., 11 percent of high schoolers smoke on average. In Kentucky, that rate jumps to 17 percent, and 2,900 Kentucky children become new daily smokers each year. According to the Coalition, 119,000 Kentucky children will die prematurely in adulthood from smoking if those rates are not reduced.

According to the Centers for Disease Control and Prevention, smoking harms nearly every organ in the body and is the leading cause of preventable death.

"Cigarette smoking causes more than 480,000 deaths each year in the United States. This is nearly one in five deaths," the CDC reports.

Estimates show smoking increases the risk:

• For coronary heart disease by 2 to 4 times

• For stroke by 2 to 4 times

• Of men developing lung cancer by 25 times

• Of women developing lung cancer by 25.7 times.

Smoke contributes to cardiovascular diseases, respiratory disease, bone health, tooth loss and gum disease and even arthritis.

Having these graphic warnings might mean the difference between life and death or debilitating disease for the many smokers who will see them on each of their packs of cigarettes.

The images show the real-life consequences of smoking and the risks taken with each cigarette.

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