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Convincing Women to Quit Smoking

The national advertising effort to "un-sell" smoking is for the first time aiming its messages at adult women in a campaign notable for its unflinchingly frank depiction of the damage cigarettes can do.

The campaign, with a budget estimated at $5.2 million, is scheduled to appear in May and June issues of two dozen weekly and monthly publications ranging from Allure and Good Housekeeping to Entertainment Weekly and Jane. One title on the media schedule, Lucky, is ironic under the circumstances because the goal of the campaign, by Arnold Worldwide in Boston, is to demonstrate the unfortunate fates that can befall female smokers.

The hard-hitting campaign, on behalf of the American Legacy Foundation, exemplifies the work being done in the realm of discovering whether advertising can effectively change behaviors other than shopping habits or buying patterns. The debate over the efficacy of those campaigns has been heated and will undoubtedly intensify as more such ads appear.

The foundation is financed by the 1998 settlement between the major cigarette marketers and the attorneys general of 46 states. It is best known for ads aimed at discouraging children and teenagers from smoking, which appear under the banner Truth and take a different approach from the new campaign aimed at older women.

The Truth campaign is focused on convincing younger consumers that the tobacco companies are nefariously targeting them in order to replace the hundreds of thousands of people who die each year from smoking-related illnesses. That campaign, by Arnold and Crispin Porter & Bogusky in Miami, has a "gotcha" tone and attitude, presenting facts about the ingredients in cigarettes and the effects of smoking in a way that suggests the tobacco companies are conspiring to keep such information from children and teenagers.

That tack is taken because research by the foundation indicates that youngsters believe themselves to be invulnerable and dislike being told what to do by authority figures. Thus pitches intended to show them what smoking could do to them decades from now, delivered in stentorian, voice-of-God pronouncements, usually fail. Anti-smoking activists criticize most of the anti-smoking ads produced for the cigarette makers because, they say, the ads take exactly the approach that guarantee they will be ignored.

By comparison, the new campaign recognizes that older women would be receptive to a no-nonsense, realistic appeal centered on the consequences of smoking, which are displayed through graphic, black-and-white photographs of women who are suffering or dying from diseases related to smoking like cancer and emphysema. Alongside the photos, by the renowned fashion photographer Richard Avedon, are brief letters written by the women to their children and husbands as well as to the tobacco companies.

"Smoking is the leading cause of death in women in the United States" through lung cancer and heart disease, says Cheryl Healton, president and chief executive of the foundation in Washington, "but only 13 percent of women we surveyed last year were aware of that."

"Even though the rate of smoking in older women has declined slightly," she adds, "the death rate is rising markedly," the result of women who began smoking decades ago now falling ill.

"About 67,000 women each year lose their lives to lung cancer," Ms. Healton says, "which is about 22,000 more than die of breast cancer."

"I think of lung cancer as the dirty little secret swept under the rug," she adds. This ad campaign is designed to take it out from there."

The purpose of the ads is to act "as a catalyst for change," Ms. Healton says, as well as "to stop blaming women addicted to cigarettes and start helping them."

"That's not to say smokers don't bear some responsibility," she adds, "but nicotine is more addictive than heroin or cocaine and one of four Americans still smoke and each loses 14 to 17 years of his or her life."

After deciding to concentrate a campaign on older women, Arnold tested several ideas and decided the best was the one that would present the stories of actual patients, who were found through casting agencies at hospitals and other medical sites in New York. The women chosen to appear in the initial four ads were then asked to write the letters that would accompany their photos.

The first ad that is running, of a woman named Linda, shows her crying, a searing image that is likely to remain for some time in the minds of those who see it. Next to the photo are excerpts from her letters.

To her three children, Linda writes: "We're running out of tomorrows. I'm so proud of you! I always loved you and always will. Goodbye, my darlings."

To her husband, Linda writes: "I am so sorry my smoking will cheat us out of 20 or 30 more years together. Remember the fun we had every year at the lake. I will always love and treasure you."

Finally, there is her letter addressed "to the tobacco companies," which discloses that she is "dying from emphysema from smoking" and concludes: "We know you are in this for the money. We are in it for our lives and the lives of our loved ones. And we will win!"

The second ad scheduled to appear, showing a woman named Desmonda, includes letters in which she apologizes to her family and children for losing "years I should be spending with you." In her letter to the tobacco companies, she declares: "You stole my dignity. You killed the spirit of a beautiful young woman. And the worst is yet to come. For that, you should be sorry."

Ms. Healton says: "I smoked for many years and quit about 10 years ago. I'm not sure I could write a letter to my children saying goodbye. It takes a lot of guts."

Each ad includes a toll-free telephone number (1-800-4-A-LEGACY) and a Web site address (www.americanlegacy.org) where more information may be obtained on how to quit smoking.

"We needed a message to go out to women to show the loss of other women from tobacco," says Pete Favat, creative director at Arnold, part of the Arnold Worldwide Partners division of Havas, which "had to use a different language from the one we use to talk to teenagers."

"Your target and the way you talk to them is very important," he adds. "The tobacco industry has always used emotion and shown how you'll appear when you smoke their product - with young, slim models - so we said: 'Let's make it extremely emotional. Let's show the reality.' "

The agency and the foundation are particularly pleased that Mr. Avedon agreed to shoot the photos, Mr. Favat says, because of "his ability to capture an authentic moment, a look in a face."

"The key to this campaign is connection," he adds, "and you can feel the genuine humanity coming through."

"The feedback from women who've seen this is what we were going for," Mr. Favat says, citing comments like " 'That image really stopped me.'"

As for the letters, he adds, "the concept was for women to leave behind their legacies" and describe "the devastation tobacco causes."

The other magazines in which the ads will appear, in addition to those mentioned above, are: Cosmopolitan, Glamour, House & Garden, House Beautiful, Marie Claire, Money, Parenting, The New Yorker, O The Oprah Magazine, Redbook, Self, Time, Town and Country, Vanity Fair and Vogue. The first of them went on sale May 7 and the last of them go on sale today.

Anti-smoking activists have long complained that many magazines, particularly women's magazines, do not devote editorial coverage of smoking that sufficiently reflects the toll it takes, which for women amounts to about 178,000 a year.

"A change in coverage is very much one of our goals," Ms. Healton says. Most of the magazines that are carrying the ads also take tobacco advertising while some like Good Housekeeping and The New Yorker refuse cigarette ad pages.

Ms. Healton and Arnold say they hope they can expand the campaign at some time to include commercials because, as Mr. Favat puts it, "It would make great television."


Stuart Elliott, The New York Times. May 28, 2002

Copyright © 2002 The New York Times Company. All rights reserved.