If a few words on the side of a pack of cigarettes won’t work, how about a picture of bloody urine on the front?

The U.S. Food and Drug Administration plans to up its game in warning smokers of the proven dangers of cigarette use.

Starting sometime next year, the warnings will occupy the top half of the front and rear panels of cigarette packages and at least 20% of the area at the top of cigarette advertisements. The lesser-known but serious health effects of smoking — including head and neck cancer, bladder cancer, stunted fetal growth, blindness and amputations — will be depicted in words and realistic color images.

If the Surgeon General’s warning didn’t get smokers’ attention, perhaps pictures of an emaciated child taking oxygen or a man with an enormous chest surgery scar will do the trick.

“As a cancer doctor and researcher, I am well aware of the staggering toll inflicted on the public health by tobacco products, which cause cancer, heart disease, stroke, emphysema and other medical problems,” said Dr. Ned Sharpless, acting FDA commissioner. “Given that tobacco use is still the leading cause of preventable disease and death in the U.S., there’s a lot at stake to ensure the public understands these risks.”

About 34.3 million U.S. adults and nearly 1.4 million U.S. kids ages 12-17 smoke cigarettes. Tobacco use — largely cigarette smoking and secondhand smoke exposure — kills about 480,000 Americans every year, more than alcohol, HIV, car accidents, illegal drugs, murders and suicides combined. Tobacco use costs more than $300 billion a year in direct health care costs and lost productivity.

We applaud the FDA’s latest anti-smoking efforts, even if its ability to change the habits of lifetime smokers will be limited. Nicotine is an addictive drug that can be harder to break than heroin. We think most smokers are well aware of the health risks they are taking, and the vast majority would quit if they could. Many have tried repeatedly.

The real audience here is new, young smokers — replacement buyers for the cigarette users who die every year. If Big Tobacco runs to court to block the FDA’s efforts, you can bet it’s because the lords of smoke fear they might lose that audience if the truth is displayed.

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Editorial Pages Editor

Wayne is the editorial pages editor of the Tulsa World and a political columnist. A fourth-generation Oklahoman, he previously served as the World’s city editor for 13 years and as a reporter at the state Capitol of four years. Phone: 918-581-8308