Thanks to the many advocates voicing their opinions through social media, I decided to pick up the phone and call the American Cancer Society (ACS) and The Centers for Disease Control and Prevention (CDC) last week regarding the new round of ads that are a part of the “Tips From Former Smokers“ campaign. This public health campaign has been creating buzz online due to its portrayal of real-life challenges linked to smoking; specifically, life with an ostomy after colorectal cancer. The ads are everywhere – online, billboards, TV. I’ve seen a commercial from this campaign nearly every night.

View the new videos creating a stir.

The Campaign & The Concerns

Several weeks ago it was clear that some of these new ads did not sit well with many within the colorectal cancer and ostomy support communities. The concerns arose from what many feel is negative portrayal of someone living with an ostomy. The choice to receive a colostomy is difficult and it can take great courage to live life with an ostomy. For some patients, their ostomies may be a point of embarrassment due to public stigmas. It’s a harsh reality that ostomates who overcome great odds deal with on a daily basis!

The ads in the campaign showed two colorectal cancer patients. Julia, 58, smoked for more than 20 years before she developed colon cancer at age 59, she now wears an ostomy bag taped to her abdomen. Mark, who developed rectal cancer at age 42, is also in the campaign and shares a tip for dealing with an ostomy.

The United Ostomy Associations of America (UOAA) swiftly wrote a letter in response to these ads underscoring the need to stop portraying people with ostomies in a negative light. The colorectal cancer community also voiced support for any ostomates living with a permanent or temporary ostomy – many who make the choice in order to save their lives.

But what prompted this?

While we understood the backlash of the community and empathized with patients who took offense, we couldn’t help but ask ourselves – what prompted this campaign and these messages?

That’s when I got on the phone and started asking questions.

The 32nd Surgeon General report on tobacco indicated that smoking causes diabetes, colorectal and liver cancer, rheumatoid arthritis, erectile dysfunction, impaired fertility and immune system weakness. In this report there were thirteen cancers linked to smoking and secondhand smoke. Liver and colorectal cancer were new to the list of cancers directly linked to smoking.

Smoking Causes Colorectal Cancer

Because many Americans do not know that smoking can cause colorectal cancer, and because colorectal cancer is the second deadliest cancer that affects both men and women in the United States, the CDC intended to highlight this fact to the general public. It’s no longer in question that there’s a link between CRC and smoking. We discussed this in length via the phone.

I then went and watched the whole series of ads from this year. Between viewing the entire campaign’s videos and speaking directly with the CDC, there’s no doubt in my mind that their intent was to educate the public of this risk factor and encourage smokers to stop.

It’s Imperative To Get Kids to Not Smoke

Some 5.6 million children living today will die early because of smoking if current rates continue. The Surgeon General’s report highlights that 87% of smokers had their first puff on a cigarette under the age of 18. Dr. Boris Lushniak is the acting Surgeon General and it seems he is passionate about addressing smoking amongst our youth. The CDC explained to me the campaign was created to be graphic, blunt and shocking. It is not lost on us that this was intentionally made to scare kids from ever taking that first puff of smoke, similar to many other anti-smoking campaigns over the years. They have evidence to say these shocking campaigns work with kids.

The “Tips” Campaigns Work for Anti-Smoking

The goal of the “Tips from Former Smokers” campaign is to encourage smokers to quit. While many Tips ads are hard-hitting and can be difficult to watch, they are effective. To date, more than 1.5 million Americans have tried to quit smoking and more than 100,000 have permanently quit because they saw the ads. Thus far in 2015, the Tips campaign has helped generate a more than a 70% increase in calls to the helpline over the three weeks preceding the start of the campaign.

Julia & Mark – They Speak Out

Not only was it important that we understood why the CDC created these ads, but it was equally important to me to know why these two survivors agreed to do this. What motivated them to be a part of this campaign?

I asked the Associate Director for Policy of the CDC’s Office on Smoking and Health to help us get their side of the story.

Julia shared with us why she wanted to do this campaign:


When I found out I had colorectal cancer, it scared me to death. Cancer is a terrifying experience. Not only was I in extreme pain, I didn’t have time to truly understand what was happening to me and how it would it affect my family. For the next year, I struggled to recover from surgery, received chemotherapy and lived in fear. I feared for my life, and for my son. What would happen to him if I wasn’t there?

My family and my doctors are a godsend. The screening I received for colon cancer the day I was diagnosed saved my life. With the help and care I received from my family, I recovered after a long road. I am blessed to say that I am remission and living a happy, healthy life.

I shared my story with the Tips From Former Smokers campaign because now I know firsthand how dangerous smoking can be. I didn’t learn smoking can cause colorectal until my diagnosis. To be honest, I didn’t even know how long I had smoked until I contacted the CDC. When I went back and counted the years I smoked, it was horrifying. Thinking about my son and the kids at the school where I work, I want all of them to be healthy and to never smoke. I don’t wish cancer on anyone.

My hope is that my message will get smokers to quit, for themselves and their families. – Julia

Mark, an active CRC advocate, shared:


One of the things I remember thinking when I was diagnosed with colorectal cancer was all the times I thought about quitting smoking. I knew smoking was bad for me, and I knew I needed to quit. I even tried a number of times.

In 2009, after experiencing symptoms that I couldn’t explain away, I saw my doctor, who referred me to a GI specialist and I underwent a sigmoidoscopy. I was diagnosed with colorectal cancer and began the fight of my life. There were tests, procedures, radiation, chemotherapy, surgery, and more chemotherapy. It was scary at times, often painful, and sometimes embarrassing, but I reminded myself every time I felt scared, or in pain, ‘it’s necessary.’ It didn’t matter how much it hurt, how much work I missed, or what people thought about me. What mattered was surviving, to be there for my wife and daughter.

I am blessed. I’m a survivor, cancer-free for five-and-a-half years post surgery. I am healthy, smoke-free, and I’m here for my family.

I know my life has a purpose. Because I’m a survivor, I owe it to others to pay it forward. If sharing my story with the Tips From Former Smokers Campaign helps anyone to quit smoking or to get screened for colon cancer, then I’ve fulfilled part of that purpose.

If you smoke, do whatever you need to do to quit smoking and, if you’re having symptoms, get screened for colorectal cancer. You’re worth it. – Mark

So, what do we (FIGHT CRC) do about this?

We want to be clear that our team does not have control over the content of these ads, nor the choices regarding the campaign now or in the future. But, we feel as an advocacy organization we have a responsibility to ensure the patient voice is heard (from all sides), that the facts are examined and the story behind the story is told.

Our colleagues at the CDC have taken the 80% by 2018 pledge and are working alongside all of us to increase colorectal cancer screening rates. This means they are looking at unique audiences – one being smokers. With that in mind, they created a campaign with the intent of anti-smoking and didn’t intend to negatively position or offend those wearing ostomies.

I have made several calls to represent our advocates’ voiced concerns about these ads, and in less than 24 hours the leaders who are in charge of this campaign responded.

Now what?

The CDC will continue to implement this campaign and run the ads. But, as I step back and look at the entire story, I go back to something that struck me during one of the calls.

After reading the articles, letters, comments by survivors with ostomies and the Surgeon General’s report, an executive from ACS said, “It is now clear based in the Surgeon General’s report we know, without a doubt, that the science shows a clear link between smoking and colorectal cancer. We know that smoking causes colorectal cancer…the science has proven that.” 

The fact that smoking causes CRC needs to be the message we get out to the public – this message cannot get lost.

I’m told by CDC that this campaign will run for the next three months, but that they have re-edited Mark and Julia’s PSAs to reduce the amount of footage showing Julia’s fears of leaving the house in the early days of having an ostomy.

For me personally, it was important to hear the survivor’s side of the story and their motivations. I commend Mark and Julia’s strength. I know it took courage to not only share their stories – but also provide comments to us in the midst of this controversy.

As I watch these ads now, I see them for the purpose they were made: anti-smoking. I do hope they scare kids from ever trying a cigarette. I hope they prevent colorectal cancer for those who need one more reason to stop. I hope that we continue to highlight the courage and strength of those who live with ostomies.

Without a doubt, an unintended byproduct of the campaign has been the importance of combating stigmas associated with life with an ostomy and getting this into the public for discussion. That is not a bad thing, in fact it’s a very good thing.

We can’t forget the important message that it’s no longer said smoking might cause colorectal cancer – it’s now proven that it DOES.

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6 comments on “Our Response & Action to the CDC’s Ostomy Ads”

  1. 1
    kathleen on July 28, 2015

    I agree with Lori and Lauren.

    I have never taken so much as a puff of a cig in my life (I’m 32). I have Ulcerative Colitis and Crohn’s and am waiting surgery to have my entire colon removed.

    Like the other ladies said, yes the dangers of smoking need to be addressed. However, I feel like, as a patient waiting for this life saving surgery, this was a backhanded approach. I am already apprehensive about the surgery and your message just told me my life is basically going to be a living hell. I was greatly disheartened by your message And thought it could have been done better and gotten the same point across. You pretty much just renewed the stigma that people in my shoes are trying to eradicate.

  2. 2
    Mandy Roberts on April 21, 2015

    i was diagnosed with stage 3c colorectal cancer at the age of 36 in October 2013. I had quit smoking 5 months earlier and specifically asked my oncologist if this could be related to my years of smoking. He said no. Colorectal cancer is one of the few types that has never been connected to smoking. My tumor was not hereditary and not from a polyp. Was he just trying to ease my guilt or is this truly brand new information?

    Thank you,

    Mandy Roberts

    1. 3
      Danielle on April 21, 2015

      Hey Mandy, this was new information released by the Surgeon General in January 2014. Up until that point smoking was a possible risk factor, but the latest report indicates for sure that smoking can cause CRC.

  3. 4
    Lori on April 21, 2015

    So I am almost two years post surgery for rectal cancer; one year post treatment protocol for my cancer. I have never smoked. I have a permanent ostomy.
    Sure smoking causes colorectal cancer. Colorectal cancer is the second deadliest cancer. That is a message that needs to be stated loud and clear. Load and clear is not the message when you do so at the expense of making an ostomy look like your life will be a “living hell” and enhancing stigmas that are already out there is society. Putting a message out there, or creating a mind set, that is not true for future colorectal cancer patients undergoing ostomy surgery is also not getting a message out there loud and clear. I believe it’s mean spirited.
    Those of us that have undergone cancer treatment for colorectal cancer and have an ostomy (or don’t for that matter) can provide a true testimony of their “own horrors of cancer treatment” without providing further disparaging messages about an ostomy surgery that is actually helping us live full, meaningful, productive, loving lives.
    So please don’t smoke is the message. Cancer treatment is truly a horrible experience and I would not wish that on anyone, is the message. Having an ostomy is not as horrible as cancer treatment…trust me!

    1. 5
      Danielle on April 21, 2015

      Thanks for the feedback & comments Lori!

    2. 6
      Lauren on June 6, 2015

      Well said Lori,

      I have a permanent ostomy because of Crohn’s. I had to have a colectomy at the age of 23 to save my life. It has had it’s major challenges to be sure and I am still dealing with all of them. As you said, I don’t think it is helpful to show ostomy surgery in this light. And honesty for me, someone who even 10 years later is still working through some issues, seeing ads like this take me to a place I’d rather not return to.
      Finally, it also begs for people who might know “your secret”, that some of us try so hard to hide and downplay, to assume things and stigmatize you.

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