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FDA  targets teens in its first anti-smoking campaign

They’re not scared of lung cancer and they can’t imagine ever developing heart disease. So the Food and Drug Administration is trying to get at what might really scare teenagers in its first campaign against smoking: looking ugly and stupid.

The $115 million “Real Cost” campaign uses a little humor and a few scare tactics to discourage teens from ever starting to smoke.

Advertisements will run in more than 200 markets throughout the U.S. for at least one year beginning Feb. 11. The campaign will include ads on TV stations such as MTV and print spots in magazines like Teen Vogue. It also will use social media.

"Our kids are the replacement customers for the addicted adult smokers who die or quit each day," said Mitch Zeller, the director of the FDA's Center for Tobacco Products. "And that's why we think it's so important to reach out to them — not to lecture them, not to throw statistics at them — but to reach them in a way that will get them to rethink their relationship with tobacco use."

Zeller, who oversaw the anti-tobacco "Truth" campaign while working at the nonprofit American Legacy Foundation in the early 2000s, called the new campaign a "compelling, provocative and somewhat graphic way" of grabbing the attention of more than 10 million young people ages 12 to 17 that are open to, or are already experimenting with, cigarettes.

According to the FDA, nearly 90 percent of adult smokers started using cigarettes by age 18. 

Nearly 700 youth take up smoking every day and tobacco companies are reaching out to them with candy-flavored mini-cigars and e-cigarettes. Advocates want to raise the smoking age to 21, and they say advertising campaigns work to discourage smokers. The agency aims to reduce the number of youth cigarette smokers by at least 300,000 within three years.

"Substantial scientific evidence shows that mass media campaigns reduce the number of children who start smoking and increase the number of smokers who quit, saving lives and health care dollars," The Capaign for Tobacco-Free Kids says in a statement. "Public health authorities including the Surgeon General, the National Cancer Institute, the Institute of Medicine and the Centers for Disease Control and Prevention have all examined the evidence and concluded that these campaigns work," it adds.

"While most teens understand the serious health risks associated with tobacco use, they often don't believe the long-term consequences will ever apply to them," said FDA Commissioner Dr. Margaret Hamburg. "We'll highlight some of the real costs and health consequences associated with tobacco use by focusing on some of the things that really matter to teens — their outward appearance and having control and independence over their lives."

Two of the TV ads show teens walking into a corner store to buy cigarettes. When the cashier tells them it's going to cost them more than they have, the teens proceed to tear off a piece of their skin and use pliers to pull out a tooth in order to pay for their cigarettes. Other ads portray cigarettes as a man dressed in a dirty white shirt and khaki pants bullying teens and another shows teeth being destroyed by a ray gun shooting cigarettes.

The FDA is evaluating the impact of the campaign by following 8,000 people between the ages of 11 and 16 for two years to assess changes in tobacco-related knowledge, attitudes and behaviors.

The campaign announced Tuesday is the first in a series of campaigns to educate the public about the dangers of tobacco use.

In 2011, the FDA said it planned to spend about $600 million over five years on the campaigns aimed at reducing death and disease caused by tobacco, which is responsible for about 480,000 deaths a year in the U.S.

Tobacco companies are footing the bill for the campaigns through fees charged by the FDA under a 2009 law that gave the agency authority over the tobacco industry.

Future campaigns will target young adults ages 18-24 and people who influence teens, including parents, family members and peers. Other audiences of special interest include minorities, gays, people with disabilities, the military, pregnant women, people living in rural areas, and low-income people.