Federal regulators will require larger warning labels and graphics for cigarette packaging and advertisements by 2012, HHS officials announced Wednesday at the Jack Morton Auditorium.

HHS Sec. Kathleen Sebelius and other government officials introduced the initiative as part of the department’s new comprehensive tobacco control strategy.

The label will cover about half the surface area of a cigarette pack and will feature messages about the negative health consequences of smoking as a way to encourage tobacco users to quit, as well as prevent young people from starting to smoke.

“Today marks an important milestone in protecting our children and the health of the American public,” Sebelius said Wednesday.

Proposed graphics include depictions of young children around cigarette smoke, diseased lungs and dead bodies.

The Food and Drug Administration will ultimately choose nine new warning statements and graphics by June 22, 2011, after a public comment period on the 36 proposed images – revealed at Wednesday’s event – ends Jan. 9, 2011. An 18,000-person study and a review of scientific literature will also help determine the images.

Sebelius noted during a question-and-answer period at the announcement that the study had various age groups, including younger populations.

By Sept. 22, 2012, the final rule on the warnings will be implemented, meaning manufacturers will not be able to make cigarettes for distribution in the U.S. without the new labels. Advertisements in the U.S. also won’t be allowed without the warnings.

“The ones that are selected [tobacco companies will] be required to use, and there will be a mandate for them to mix them up, so to speak, so that when you go to the store there will be the combination of different, of the nine pictures,” FDA Commissioner Margaret A. Hamburg said.

She said images could change later, depending on continuing research about the effects of the graphics.

“Over time, in addition to changing the graphic images, if we feel there’s a reason to do so we can also modify the specific warning message,” Hamburg said.

Some of the warnings set to be used are “Cigarettes are addictive,” “Tobacco smoke can harm your children” and “Smoking can kill you.”

Hamburg said the nine warning messages were definite, but the proposed graphics accompanying them are still undecided.

Caroline Sparks, an associate professor and director of the Health Promotion program in GW’s School of Public Health and Health Services, asked if the warnings would also appear on websites that promote tobacco.

Hamburg said the Internet is complex since responsibility can extend across governments, and that actions being taken with the new warnings specifically have to do with cigarette packaging and print advertisements.

Howard Koh, the United States Assistant Secretary for Health and the chair of the working group that developed the department’s action plan for tobacco control, told Sparks that an initiative over the summer called the Prevent All Cigarette Trafficking Act is intended to stop the illegal sale of tobacco products over the Internet, something he called an advance in public health.

“[The Internet] is another avenue where kids can get access, and we need to make sure that kids can stay tobacco-free, so that PACT initiative really starts us down the right road,” Koh said.

As for the cost related to the new warnings, Hamburg said the tobacco program at the FDA is supported by user fees from the tobacco industry.