U.S. to launch graphic anti-smoking warnings

By Dr. Ananya Mandal, MDMar 18 2012

The United States Government is starting a major new effort to cut the country's smoking rate by showing graphic images of people who have sustained life-altering health problems after smoking for years.

The U.S. smoking rate peaked at more than 40 percent of the adult population in the mid-1960s, but government health officials say the rates have stagnated at about 20 percent in the last decade, a rate substantially lower than in some European and Asian countries, but still higher than in other places. One recent study showed that one out of four high school seniors in the country is a regular cigarette smoker, a rate the government described as a “pediatric epidemic.” Smoking remains the leading cause of preventable death and disease in the United States, killing more than 443,000 Americans each year, according to federal estimates. More than eight million Americans live with a smoking-related disease.

The government has announced that next Monday it is starting a $54 million advertising campaign to try to shock smokers into quitting - and keep impressionable teenagers from starting what often turns into a lifetime habit. The 12-week advertising blitz, called “Tips From Former Smokers,” is an effort to counteract the estimated $10.5 billion a year spent by tobacco companies to market and promote cigarettes in the United States.

The Centers for Disease Control and Prevention said Thursday that it will place the ads on billboards, radio, television and social media sites in a three-month effort. California has spent about $20 million annually since 2000 on anti-tobacco advertising, while New York spent about $10 million annually between 2003 and 2009. Other states also finance such ads.

Dr. Thomas R. Frieden, the C.D.C.’s director, said the campaign would save lives and money. “We estimate that this campaign will help about 50,000 smokers to quit smoking,” Dr. Frieden said Wednesday in an interview. “And that will translate not only into thousands who will not die from smoking but it will pay for itself in a few years in reduced health costs.”

One of the ads depicts a 31-year-old man who is a double amputee who lost his legs because of a rare blood disorder caused by smoking. The ad says, “Allow extra time in the morning to put on your legs.”

In one TV ad, Terrie, 51, of North Carolina, who has a hole in her neck and barely any hair on her head after suffering head and neck cancer, tells the camera, “I want to give you some tips about getting ready in the morning.” She then pops in a set of false teeth, dons a blond wig and inserts a small speaker into the tracheotomy in her neck. She ties on a scarf to hide the device and says, “And now you’re ready for the day.” An announcer says: “You can quit. For free help, call 1-800-QUIT-NOW.”

“For every person who dies from smoking, at least two new young smokers take their place,” Kathleen Sebelius, secretary of Health and Human Services, said at a news briefing launching the campaign. She said the ads - a combination of paid advertising and public service announcements - are intended to encourage smokers to quit and to build awareness for the damage caused by smoking and exposure to second-hand smoke. “The ad campaign we are launching today will tell the real story. The courageous individuals who volunteered to be in this campaign lost lungs, legs, fingers and the ability to speak as a result of smoking's toll,” she said. “We hope these ads, based on successful campaigns in several states, will be a wake-up call to smokers and potential smokers who are not yet aware of the enormous damage they may be doing to their health.”

David Howard, a spokesman for the R. J. Reynolds Tobacco Company, which makes Camel and Pall Mall cigarettes, declined to comment directly on the advertising campaign because he had not seen it. “We believe that adult tobacco consumers should be provided with accurate information about the risks associated with tobacco use,” he said.

R. J. Reynolds is part of a group of tobacco makers that have sued the Food and Drug Administration to overturn rules that would require cigarette companies to cover much of their packaging with graphic warning labels. Two weeks ago, a federal judge in Washington declared the rules an unconstitutional violation of the companies’ free speech rights. The government is appealing.

Mr. Howard said that he doubted that tobacco companies would raise similar objections to the CDC advertising campaign since it would not involve “taking our packaging to deliver anti-tobacco information.”

Dr. John Seffrin, chief executive of the American Cancer Society, said that cancer mortality rates are dropping faster than ever in the United States, and that the reduction in the proportion of Americans who smoke is one of the main reasons. He noted that a third of all cancers are directly attributable to smoking, and that many smoking-related cancers are unusually deadly and expensive to treat. “If this ad campaign helps people quit and prevents some from starting, it’s the right thing to do,” he said. Along with vaccinations, few public health efforts have the capacity to save as many lives as those that combat smoking.

“I’ve been waiting for the government to do this for 40 years,” said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids. “Even in the tightest budget times, this is absolutely the right thing to do.”

“We agree smoking is addictive and causes serious disease and for those who want to avoid the health effects of smoking, the best thing to do is to quit,” said Steve Callahan, a spokesman at Altria Group, parent of companies Philip Morris USA, U.S. Smokeless Tobacco and John Middleton.

Dr. Len Lichtenfeld of the American Cancer Society said the ads are a good step, but they need to be part of a coordinated anti-smoking effort that includes talking about clean indoor air, tobacco taxes and smoking cessation programs. “We have hit a barrier of smoking in this country where about 20 percent of adults are regular smokers,” Lichtenfeld said in a telephone interview. “In the past number of years, we haven't been able to reduce that number. If this campaign sends a message to people that this is a habit that has risks that can cause harm, that's a good thing,” he said.