Tobacco sales and related diseases from smoking

Massachusetts is poised to become the first state in the nation to force retailers to prominently display graphic warnings about the perils of smoking right where cigarettes are sold — at tobacco sales racks and next to cash registers.

Retailers who refuse to display the signs within 2 feet of tobacco displays and cash registers could face fines of $100 to $300.

A retail industry group reacted yesterday with dismay, arguing that cramped corner stores are already burdened by too many regulatory dictums.

Images of ominously darkened lungs, damaged brains, and diseased teeth could start appearing before the end of the year in more than 9,000 convenience stores, pharmacies, and gas stations, if a proposal by the state Department of Public Health is approved as expected. Other posters would direct smokers to where they can get help to stamp out their habit. For example on the Richmond cigarette pack will be staying a poster of a tobacco related disease or maybe an advice to help quit the habit.

Graphic images portraying the damage wrought by smoking have been a hallmark of antismoking campaigns in Europe for years. But, in the United States, admonitions on cigarette packs and at stores have tended to rely on words rather than pictures.

The initiative needs the approval of the state Public Health Council — an appointed panel of doctors, disease trackers, and consumer activists — but board members yesterday expressed unequivocal support. Since the 1990s, Massachusetts has been at the vanguard of US efforts to reduce tobacco use, the leading cause of preventable deaths in the United States.

 “If somebody is trying to quit smoking and they go back to the store and they’re tempted — oh, just one pack — we hope this will help them make a different choice,’’ said Lois Keithly, director of the Massachusetts Tobacco Cessation and Prevention Program.

The signs are modeled on a nothing-left-to-the-imagination campaign in New York City, where signs showing the health effects of smoking began sprouting in 11,500 shops last December. Massachusetts health authorities provided copies of the New York City posters as an illustration of what their campaign will look like.

The campaign is being underwritten by $316,000 in federal stimulus money from the Centers for Disease Control and Prevention, which will allow the state to provide the materials to retailers without charge. “And they’re just very ineffective at this point,’’ said Eileen Sullivan, policy director for the state’s tobacco control program.

The Retailers Association of Massachusetts has not decided how gamely it will fight the proposal, but the organization’s president, Jon Hurst, left little doubt that most shopkeepers will respond coolly to another mandate. That may prove especially true at convenience stores, where tobacco sales constitute a significant share of business.