Cigarette packaging could see their biggest design change in the past 35 years if the U.S. Food and Drug Administration has its way. The FDA has just revealed a new proposed rule that would require manufacturers to include graphic health warnings on all cigarette packages and advertising. The proposed rule is open for public comments for 60 days, ending on Oct. 15, 2019. The FDA is seeking public comments on alternative text and images and any scientific information that supports a finding that the alternative text and images would advance the government interest in helping the general public understand the true consequences associated with cigarette smoking.

With nearly 34.3 million U.S. adults and nearly 1.4 million U.S. youth currently smoking cigarettes (according to the FDA), the agency feels realistic photo warnings on cigarette packages could help keep more people from smoking cigarettes. The proposed warnings would depict a range of health risks associated with cigarette smoking including diabetes, diabetes, and bladder cancer, among other conditions. The last time cigarette packages underwent a change like this was in 1984 when surgeon general’s warnings were added to packages and advertisements.

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