FDA campaign takes new angle to target teen smoking

In an attempt to scare teens away from cigarettes, the US Food and Drug Administration has launched a $115 million ad campaign that doesn’t mention lung cancer, heart disease, or emphysema, not even once. No body bags will surface, and no smoke will rise from a hole in the throat like the FDA’s last effort to create graphic warning labels. (The warnings were trashed after cigarette manufacturers sued to keep from being forced to feature them on their products.)

This time, the FDA has taken a different tack, highlighting the downsides of smoking that teens may have an easier time relating to: it yellows teeth, causes wrinkles, damages skin, steals your money, and forces you away from your friends to feed nicotine cravings.

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Starting next week, “The Real Cost” ad campaign will run for a year on websites, TV, the Internet, and in magazines aimed at teens.

“We’re reaching kids on the cusp,” said FDA commissioner Dr. Margaret Hamburg at a press briefing Tuesday morning. “They’re one party away from trying their first cigarette or have already experimented,” she said, but they haven’t yet been hooked.

Previous research suggests that teens aren’t really scared off from smoking by the possibility of getting lung cancer or heart disease down the road. “They’re not thinking about tomorrow,” said FDA tobacco education director Kathy Crosby. “They don’t believe they’ll ever get addicted.” But, added Hamburg, 700 American teens do, on a daily basis.

Whether the campaign will keep teens from lighting up remains anyone’s guess.

One ad features a teenage girl places money on the counter to buy a pack of cigarettes and the cashier says, “you need a little more honey.” The girl proceeds to peel off a section of skin from her face, making the point that cigarettes cost smooth skin as well as money. In another ad that’s particularly grimace-inducing, a teen boy is forced to remove a tooth with a pair of pliers when he purchases his pack.

Other ads make cigarettes into bullies: “Hey, when I say pause the movie, we pause the movie!” screams a tiny cigarette-sized man with long greasy hair who proceeds to drag the teen outside by his collar.

“I’m surprised the FDA would do this kind of messaging,” said Dr. Gregory Connolly, a tobacco control expert at the Harvard School of Public Health. “Young people are smart and you never want to do messaging that insults their intelligence like someone pulling skin off their face.”

When Connolly directed smoking prevention efforts at the state Department of Public Health 15 years ago, he launched an ad campaign featuring Pam Laffin, a 20-something mother who started smoking at age 11 and was dying of emphysema. “Teen girls told us in surveys that they could relate to her,” Connolly said. “Her story was believable but not over the top.”

The FDA showed the commercials to 1,600 teens in their target audience, who reported that they were “memorable, understandable and engaging,” said Mitch Zeller, director of the FDA Center for Tobacco Products. The agency also surveyed 8,000 adolescents from around the country on their attitudes about smoking and will continue to follow them through the ad campaign to see whether their attitudes change after they are presumably exposed to the commercials repeatedly over the next 12 months.

Much progress has already been made to reduce teen smoking—fewer than 9 percent of teens under 18 are regular smokers compared to 13 percent back in the 1990s. But the decline has slowed, according to Hamburg, and the agency hopes this initiative will speed it up.