This post has been updated.
The United Ostomy Associations of America has asked the Centers for Disease Control and Prevention to pull two chilling anti-smoking ads that emphasize the difficulty of living with the aftermath of intestinal surgery.
In a letter to a top CDC official, the group's president said the taxpayer-funded videos reinforce outdated information and perpetuate stigmas it has battled for years.
"Your message--funded by taxpayer dollars and splayed across national media--that having ostomy surgery is miserable and should be avoided/delayed at all costs is both offensive and dangerous," Susan Burns, the group's president wrote on April 13. She predicted that people who view the ads will refuse or delay "lifesaving surgeries," in part because they come from a trusted source of health advice, the CDC.
"We know that your ads are undermining what we have done to empower, educate and reduce the stigma of ostomy surgery," Burns wrote to Tim McAfee, director of the CDC's Office on Smoking and Health.
When parts of the intestine or bladder are removed, it is sometimes necessary for surgeons to create an opening in the abdomen for removal of body waste, called an ostomy. The waste flows into a bag that is attached to a small portion of the intestine or ureter that extends beyond the skin, called a stoma. The openings can be temporary or permanent. Burns's group estimates that about 750,000 people may be living with ostomies.
In an e-mail, CDC spokeswoman Belsie Gonzalez replied that "our goal was not to offend or to stigmatize people who have ostomies, but to educate people who smoke that having an ostomy is one possible consequence if they continue. The reality is that smoking kills nearly half-a-million people each year, and for every person who dies from smoking, at least 30 people are living with a smoking-related disease, including colorectal cancer."
The CDC's $68 million ad campaign is designed to be shocking. It follows a $48 million campaign that the CDC has said persuaded 100,000 people to quit smoking for at least six months at a cost of just $480 per quitter.
In one version of the ad, shown above, a 58-year-old Mississippi woman, Julia, notes her two surgeries for colorectal cancer and says "what I hated most was the ostomy bag." Holding up an empty ostomy bag, she adds: "My tip is get over being squeamish. You're going to be emptying your bag six times a day."
In a longer version of the ad, Julia says: "You go whenever it goes. You have no control. If it comes loose, it smells. I had to wear it for a whole year."
In another ad, a 47-year-old named Mark says that "there was a chance they would not have been able to reconnect the portions of my colon. I remember, in fact, the surgeon telling me 'you won't know until you wake up if you're going to have a permanent colostomy bag.'"
Lois Fink, a patient advocate with the ostomy organization who had surgery for Crohn's disease in 1986 that left her with an ostomy, said the CDC campaign emphasizes "all of the fears that people have about ostomy."
"It's viewed as the worst possible surgery you could ever have," she said. "'You're going to be a recluse, you can't leave the house, you're going to leak, you're going to smell.'" In fact, she said, none of that is true, in particular leaks which, she said, rarely occur if someone is receiving proper care.
"You can live a normal, active, productive life," she said. "I had no life with Crohn's disease. I was chained to a bathroom."