The Food and Drug Administration wants cigarette packs to feature graphic health warnings.

These include color photos of smoking-related illnesses.

Such warnings are required on cigarette packs in other countries but aren’t mandatory here.

Tobacco companies successfully sued to block them.

Adult smoking has declined but the Centers for Disease Control and Prevention estimate 480,000 Americans die from smoking a year.

“Given that tobacco use is still the leading cause of preventable disease and death in the US, there’s a lot at stake to ensure the public understands these risks,” said Acting FDA Commissioner Ned Sharpless.

The graphic labels would represent the biggest overhaul of cigarette-health warnings in more than 30 years.

This will test the FDA’s rule-making authority after earlier efforts were quashed.

In 2012, a group of tobacco companies convinced an appeals court that the agency’s proposed images violated their 1st Amendment rights.

The group included Reynolds American but not Altria, the US market leader.

Since 1984, labels describing the dangers of smoking have been contained in a small box with black-and-white text. But the 2009 law that gave the FDA regulatory authority over tobacco required the agency to issue new rules for color warnings on cigarette packs.

The original proposal included images of a body on an autopsy table and a man exhaling cigarette smoke through a hole in his throat.

The proposed warnings include a large tumor on a woman’s neck and a pair of feet with amputated toes.

One reads: “Smoking causes bladder cancer, which can lead to bloody urine,” accompanied by a photo of a specimen cup filled with reddish liquid.

Altria, maker of industry-leading Marlboro cigarettes, said it has been expecting the proposal.