By Pamela Ferdinand
Special to The Washington Post
Wednesday, October 14, 1998; Page A03

BOSTON—Pam Laffin, a 29-year-old mother of two, is waging the battle of her life -- and possibly, death -- on prime-time television in Massachusetts.

Laffin's struggle to survive while slowly suffocating from the debilitating and deadly lung disease emphysema is being broadcast in a six-part series of compelling and often graphic antismoking commercials sponsored by the state Department of Public Health.

The 30-second documentary-style sequences, which cost $1.5 million to produce, air through Dec. 5 during some of the season's most popular daytime and evening shows, including "ER," "Ally McBeal," "Oprah Winfrey" and "Dawson's Creek."

While state health departments elsewhere have fought smoking by attacking the tobacco industry, with mixed success, officials here say Laffin's deeply personal message is aimed at refocusing attention on individual adult smokers and encouraging them to quit.

Viewers are shown close-ups of a healthy lung next to a blackened emphysemic lung, and the loop of a transplant scar that traces under Laffin's arm and across her back. Laffin gulps air through an oxygen mask at one point and describes her terror at the thought of not being able to breathe. Her 10-year-old daughter says: "All my friends say, 'Oh, I want to be like my mom when I grow up, and I can't say that.' "

It may be a painful and often unflattering portrait, but Laffin does not regret that it may be her last. The Massachusetts Quitline, whose telephone number airs at the end of each ad, has registered a sixfold increase in calls since the commercials began last month.

"I'd give anything just to be a mom instead of some dying reminder of what not to do," Laffin says in the concluding segment. "I just hope you can learn from my life before you have to pay with your own."

The campaign is the latest indication that Massachusetts, whose earliest governor urged a tobacco ban in 1631, has no intention of retreating from its antismoking offensive in the face of intense lobbying from the tobacco industry. The second state to adopt a cigarette tax and the first to divest its pension funds of tobacco company stocks and bonds, Massachusetts also has one of the few laws requiring cigarette manufacturers to disclose their ingredients. And the city of Boston recently enacted a restaurant smoking ban.

While California, once the nation's antismoking pioneer, has lost some ground in its campaign against tobacco use, consumption here dropped by 31 percent between 1992 and early 1997, more than three times the nationwide rate. Most significantly, youth tobacco use has not spiked, state public health data show.

The department nevertheless began rethinking its advertising approach after studying an Australian campaign that portrayed the destruction cigarette smoke creates through the throat and lungs. Researchers concluded that realistic and graphic antismoking images were more effective in targeting smokers than lighter, less direct approaches.

The real-life campaign debuted earlier this year with teenage smokers describing what it was like to be addicted to cigarettes. Telling Laffin's story seemed a logical next step, said Gregory Connolly, the state's tobacco control program director.

"Adult smokers want to be told something new. They want to see some graphic material, and they want to see it personalized," he said. "It's hard not to look at Pam and say, 'That could be me.' "

Laffin, who nabbed her first cigarette when she was 10 from a free Benson & Hedges sample four-pack at the corner store, said she was inspired to start smoking by Olivia Newton-John, who wins back her man as a cigarette-smoking bad girl in the film "Grease." Laffin was later suspended for smoking in school, but allowed to smoke at home when she reached 16.

By 21, she had smoked through two pregnancies and developed a pack-a-day habit and bronchial asthma. By 23, she had chronic asthma. A year later, when she finally quit smoking, Laffin could barely raise a cigarette to her lips or stand in the shower without struggling to catch her breath. Her asthma inhaler provided no relief, and she began to suspect something was wrong.

Tests showed she had emphysema, an incurable disease caused by exposure to cigarette smoke, which gradually destroys air sacs in the lungs and reduces oxygen to the bloodstream, causing severe shortness of breath. In May 1995, her left lung was replaced with a donor lung. But her body began rejecting the new lung last year, and she needs a second transplant.

Anorexic before the first transplant and an already slight figure at 5-foot-3, Laffin has since gained 100 pounds. Her right lung has become emphysemic, swelling so much that she can feel it pressing against her trachea and left lung. Her pale, freckled face is bloated and her neck humped from steroids and a seemingly endless supply of medications ranging from immunosuppressants to sedatives and antibiotics.

Laffin knows her chance of survival is slim given her condition (she can walk only 400 feet at a stretch), the rarity of second lung transplants, and the shortage of donors. Added to that, the average wait for a new lung is about one year, which may be too long, said Joseph LoCicero III, chief of general thoracic surgery at Beth Israel Deaconess Medical Center in Boston. LoCicero, who appeared in the six-part series of television ads, said he hopes there will not be a seventh.

"Without another transplant, she probably would not live more than one or two years," he said, adding, "The cards are stacked against her, but she's doing everything she can."