(CBS/AP) "What's the big deal?" That's a question someone from another country might ask about the new cigarette warning labels just unveiled in the U.S. Some Americans were shocked by the labels' graphic images, which show rotting teeth, diseased lungs, and even a smoker's corpse. But more than 40 nations require cigarette warning labels at least as graphic the nine new U.S. labels.
The U.S. warnings - the biggest change to the labels in a quarter-century - aim to use fear and disgust to deter smoking. The FDA estimates the labels will cut the number of smokers by 213,000 in 2013, with additional reductions through 2031. Though it's impossible to attribute reduced smoking rates to a single cause, in Canada, Brazil, Thailand and other countries, strong warnings have been linked with an increase in the number of smokers trying to quit.
"We are so far behind," says Michael Cummings, who chairs the department of health behavior at Roswell Park Cancer Institute. "We're a third-world nation when it comes to educating the public on the risks of smoking."
The new labels will fill the top half - front and back - of each pack of cigarettes sold in the U.S. They will also appear in ads. Cigarette makers must run all nine labels on a rotating basis. They have until the fall of 2012 to comply.
Before the new labels were introduced, the U.S. had some of the world's weakest cigarette warnings. The U.S. first U.S. cigarette warning labels, which said simply, "Cigarettes may be hazardous to your health," were mandated in 1965. The current warning labels - put on cigarette packs in the mid-1980s - say more explicitly that smoking causes lung cancer, heart disease, and other illnesses. But they are text-only blurbs found in a small box on the side of the pack.
Uruguay has some of the world's strongest warning labels. One shows a person smoking a battery like it's a cigarette to illustrate that both products contain the toxic metal cadmium. In Brazil, labels feature graphic images of dead fetuses, hemorrhaging brains, and gangrenous feet.
Many proponents of stronger warning labels point to Canada as evidence that pictures work. Under a first-of-its-kind law passed in Canada in 2000, tobacco companies had to affix warnings about the dangers of smoking - including photos of a diseased heart or oral cancer on the tongue - on cigarette packages. Following that change, nine out of 10 Canadians surveyed demonstrated a deeper knowledge of the health consequences of smoking. The smoking rate also fell to 20 percent from 26 percent.
Matthew Myers, president of the Washington, D.C.-based advocacy group Campaign for Tobacco-Free Kids, said, "We've now seen it happen enough times in enough different cultures to feel very confident in concluding that not only do warning labels change knowledge and beliefs, they change behavior."
Tobacco kills 443,000 Americans a year.