A stop smoking campaign which shows a tumour growing from a cigarette will be launched on Friday.
They are the first shock anti-smoking adverts since the fatty cigarette ad eight years ago.
According to the Department of Health (DoH), just 15 cigarettes can cause a mutation than can lead to cancerous tumours.
Chief Medical Officer Professor Dame Sally Davies said smokers play Russian roulette with every cigarette.
"This is a hard-hitting campaign to get at the hidden harms of smoking," she said.
"People will see a man smoking and then a cancer growing out of the cigarette. That is what happens in people's bodies.
"One-in-two smokers die from smoking, most from cancer. We know that people don't personalise the harms of smoking and don't understand what's happening in their bodies. This will show them."
The advert shows a cancerous tumour growing out of a cigarette
The campaign is in response to statistics which show more than a third of smokers still think the health risks are greatly exaggerated, the DoH said. Dame Sally described the figures as "absolutely shocking".
The last graphic adverts, in 2004, showed fatty deposits being squeezed from a smoker's artery and fat dripping from the end of cigarettes. The following eight years have seen softer campaigns but the DoH says it believes the time is right to deliver a stronger message.
Dame Sally said: "It is extremely worrying that people still underestimate the serious health harms associated with smoking. We want smokers to understand that each packet of cigarettes increases their risk of cancer."
The campaign, which cost £2.7 million, will run for nine weeks on television, billboards and online.
England's eight million smokers are being urged to pick up a free NHS Quit Kit from pharmacies.
The advert urges smokers to pick up a free NHS Quit Kit
Dr Harpal Kumar, chief executive of Cancer Research UK, insisted the startling images in the ads are necessary.
"We have got to reduce the impact that tobacco has on the lives of far too many people," he said.
"It's not a lifestyle choice, it's an addiction that creeps into people's lives and results in death and disease.
"Giving up smoking can be extremely difficult, so providing extra motivation and reminding people of just how harmful the habit is can help smokers to take that first step in quitting for good."