The graphic videos featured pleas from former smokers who had suffered amputated limbs, oral and throat cancer, paralysis, lung damage, strokes, and heart attacks. One of the most haunting showed Terrie Hall, a 52-year-old North Carolina woman whose larynx was removed after she was diagnosed with throat cancer. In the ad, she spoke with the help of an artificial voice box. Hall later died.
The campaign and the analysis were both conducted by the Centers for Disease Control and Prevention, but Saul Shiffman, a University of Pittsburgh psychology professor who has spent decades studying smoking habits, said there is no doubt it was a tremendous bargain for the public and, especially, the smokers who quit or added years to their lives. One standard used in studying such interventions considers them cost effective at $50,000 per year of life gained--more than 100 times the cost of the campaigns.
Medical interventions, such as heart and lung surgery commonly needed by long-term smokers are much more expensive than that, Shiffman noted. The money spent on the campaign "would pale next to the money we spend for medical treatment for smokers who otherwise are going to have a heart attack and lung cancer," he said.
CDC Director Thomas Frieden said the campaign is "an example of an investment that saves lives and money. Most smokers want to quit. Tips show that people can, and can save literally tens of thousands of lives, and has done so at a cost vastly lower than the cost of most other health interventions."
Shiffman and Tim McAfee, director of the CDC's Office on Smoking and Health, noted that the tobacco industry spends about $8 billion annually to promote its products. Funding for the campaign, which continued in subsequent years, comes from the Affordable Care Act.
A previous study of the effort determined that more than 100,000 people gave up smoking for six months or more, considered permanent abstinence for the purposes of the research. Another 100,000 quit for shorter periods of time and 1.6 million tried to quit after seeing the ads.
The data was derived by surveying a group of several thousand smokers before and after the ad campaign, McAfee said. About 89 percent said they had seen the ads.
The shocking nature of the campaign was designed to reach smokers, who already know that the habit is likely to sicken and kill them. They told researchers "we don’t want to die early , but we’ve kind of absorbed that message. We don’t want to suffer and we don’t want our families to suffer," McAfee said.
"What they told us [was you] need to show us in a way that we can understand or believe what the consequences of us continuing to smoke are," he said. A positive message was included at the end of the ads to highlight the fact that even smokers who quit late in life improve their health and gain quality of life, he said.
Despite declines in smoking rates, about 42 million people in the United States, 18 percent of the population, still smoke. The habit remains the single most preventable cause of death and disease in this country, the study noted.
Lena Sun contributed to this report.