Yet another reveals a heart gruesomely darkened with dead tissue, and cautionary words about how cigarettes can lead to heart attacks.

Toughest Cigarette Warnings in the World

These graphic images and warnings are among 16 the Canadian government has required tobacco companies to put on the packages of all cigarettes to be sold there. The labeling, considered the toughest imposed by any country, is part of an aggressive government effort to reduce smoking.

“I don’t think there’s any doubt the images shock,” says Dann Nichols, spokesman for the Canadian Health Department.”Anything we can possibly do to deter smokers from starting or convincing them to quit is well worth the effort.”

Approximately 25 percent of Canadians are smokers, the same rate as the United States. The Canadian federal government hopes this effort will help reduce the 43,000 deaths each year there due to smoking, according to Andrew Swift, a Canada Health Department spokesman.

Graphic Images and Gruesome Text

The new law, passed in June and put into effect last month, requires that the warning label cover half of the front of every pack, with color images. On the inside flap, firms must put the toxic contents and advice on how to quit smoking. Warning labels are printed in English and in French, on the back and the front of the packs, in accordance with Canada’s official bilingualism policy (the highest rate of smoking per capita is in Quebec).Each firm has to alternate between the 16 different images on its product.

Prior regulation in Canada only had a 25 percent-of-the-pack voluntary labeling requirement.

Public interest groups and the Canadian Health Department lobbied Parliament to pass the new stringent regulations. Government funded surveys of Canadian smokers suggested graphic images could help people quit.

Public Responds to Visual Images

“We live in a visual culture,” says Donna Dasko, a senior vice president with the Environics Research Group, a Toronto-based market research firm that used focus groups to study the labels. “A lot of people are attuned to visual images. And when they can see the image, when they can see what happens to a mouth, or a heart or a lung, it has an impact that is much greater than just the text.”

Research found that warning labels with pictures were 60 times as effective than just text alone, Swift says.

Besides the mandatory labeling, the new law requires manufacturers to report to the government information about cigarette contents, marketing, manufacturing and sales, as a way to improve cessation programs, Swift says.

Tobacco Companies Fighting Regs in Court

Tobacco companies are not happy with the new regulations and are now in court trying to reverse them.

“We don’t argue with the notion there ought to be warnings, strong, effective and regularly changed,” says Rob Parker, the president of the Canadian Tobacco Manufacturers Council. “Will these have any effect? And do they need to be 50 percent of the package, is the essence of our challenge against them.”

Canada’s ability to get such a tough anti-tobacco measure through, observers say, has to do with the relatively little influence the tobacco lobby and tobacco money have on the country’s political system. In Canada, no candidate running for federal office can spend more than $82,000. When the new cigarette warnings were first proposed in Parliament, they received the support of all five political parties.

The picture is quite different in Washington. Last year bills were introduced in the House and Senate calling for larger, bolder print on cigarette warning labels. Neither bill received a hearing. But Rep. Marty Meehan, D-Mass., says he plans to continue the fight.

“We are looking at introducing legislation in the 107th Congress that will use the Canada standard of 50 percent warning size and text as a model,” says Bill McCann, a spokesman for Meehan.