On Monday, coming to a theater near you -- and to TV, radio, online sites, newspapers and billboards as well -- the newest sequel to the national anti-smoking media campaign, "Tips from Former Smokers."
Produced by the CDC (Centers for Disease Control and Prevention), the upcoming sequel again features actual former smokers whose lives were damaged or endangered by tobacco products.
Their painfully true stories are regularly disturbing and consistently grim. In their telling, each participant hopes to encourage other smokers to quit, and to discourage prospective smokers from ever lighting up. Collectively, their messages provide a deadly serious reminder of the many -- and, perhaps, surprising -- ways that tobacco can disfigure a body, ruin a life, and cause human suffering.
In the 2014 sequel, we will meet former smokers who've lost their teeth from gum diseases, a distraught mother who delivered prematurely, and "Rose" whose lung cancer has spread to her brain. We'll additionally hear from Shawn who breathes through a hole in his neck after losing his larynx to throat cancer, and from 45-year Brian who ruefully submits, "It took a stroke for me to actually stop smoking."
Finally, we'll visit once more with Terrie Hall -- a 53-year-old woman who appeared in the original 2012 campaign, but speaking to us now from her deathbed, mere days before dying last September from complications of oral and throat cancers.
She aims her chilling last words directly at us, warning us against smoking -- a message that's brutally reinforced by the haunting image of her decaying body.
These graphic stories are difficult to watch. However, they do vividly embody what the CDC's stony statistics have been trying to convey for years about smoking's known dangers.
About the extraordinarily wide scope of smoking's potential to harm us beyond our lungs -- in our throats, mouths, brains, hearts, arteries and pregnancies. And about the 480,000 Terrie Halls who die each year in the U.S. from this leading single cause of preventable death and disease.
The CDC hopes that this summer's anti-smoking sequel will build upon the earlier successes of its two prior campaigns.
As published in the Lancet last December, an outcomes study evaluating behavioral changes during the three-month-long 2012 campaign estimated that about 1.64 million Americans had attempted to quit smoking, and about 100,000 of them were expected to remain abstinent for the conceivable future. Additionally, an estimated 6 million nonsmokers talked with smokers during the campaign about the dangers of smoking, many of them referring family and friends to cessation services.
Those positive outcomes are rather respectable for a campaign that, according to the CDC, "cost less than the tobacco industry spends in 3 days on marketing and promotion."
Still, some critics wonder if the CDC ads are too psychically or emotionally violent, unintentionally deterring additional smokers from quitting. They worry that such fear-based messages might leave some smokers feeling doomed or ashamed, disempowering them to change.
Lucy Popova, Ph.D., at UC San Francisco's Center for Tobacco Control Research and Education, offers another perspective.
First, she points to the demonstrated successes of the 2012 campaign to illustrate the potential good that could come from health-risk communications that incorporate fear-inducing stimuli. "But," she immediately cautions, "You can't just scare smokers as a strategy to help them quit."
Besides impressing upon smokers the blatant reality of their personal vulnerability to serious tobacco-related health threats, effective and empowering communication should also reinforce a high level of self-efficacy.
"In other words," Popova explains, "it means that you should simultaneously communicate to smokers that there are measures they can take in order to quit, things they're actually capable of doing in pursuit of successful quitting."
In this regard, the CDC ads offer ample resources to smokers wishing to quit -- available online at www.cdc.gov/tips or by phone (1-800-QUIT-NOW, toll-free). And, as Popova points out, the "Tips from Former Smokers" campaign is actually messaged by ... well, "former" smokers.
Anti-smoking campaigns and resources like these offer hope to the 70 percent of smokers who say they want to quit.
They provide solid and compelling evidence that it is possible to quit, possible to join the growing ranks of former smokers who now outnumber active ones in the U.S. They allow for legitimate optimism about one's chances of being successful, notwithstanding the undermining influences of the tobacco industry's $22 million-a-day habit of cigarette advertising and promotion.
Popova confidently suggests, "All smokers, make a quit attempt now. You can do it, and you have great resources to help. And for nonsmokers who want to help their loved ones to quit, these resources can help you have the conversation."
Kate Scannell is a Bay Area physician and the author of "Death of the Good Doctor."