In addition to the National Youth Tobacco Survey and other national surveys, the now-shuttered CDC Office on Smoking and Health (OSH) provided technical support and $82 million to support state health departments (zeroed out on April 26, 2025), provided through the National Tobacco Control Program, and prepared dozens of Surgeon General’s reports on smoking and tobacco (archived on the Internet Archive here, in case Trump takes down the CDC page). OSH also developed and ran the Tips from Former Smokers media campaign (archived here).
Since it was launched in 2012, the Tips campaign’s core approach has been to give a voice to real people who smoked and suffered the physical and emotional consequences of their addiction, allowing them to tell their own real stories to inspire others to quit before they develop irreversible damage. None were actors, and CDC OSH independently confirmed the details of their stories, including the role of tobacco in their conditions.
The story of one of the first Tips participants, Terrie Hall (archived here), illustrates the commitment and passion of Tips ad participants. Terrie was born in North Carolina and worked in tobacco fields as a teenager. She was prom queen at her high school where she became addicted to smoking. When she turned 40, she was diagnosed with oral cancer, received radiation treatment but shortly after was found to have cancer of her larynx (voice box). This smoking-caused cancer required surgical removal of her voice box and creation of a hole in her neck for breathing, forever destroying her natural voice. She spent years travelling across North Carolina talking with students about the harms of smoking and was eager to participate in Tips when she heard about it.
Terrie was featured in several of the Tips campaigns’ most powerful ads and served as a media spokesperson. She joined the Directors of CDC (Tom Frieden) and OSH (Tim McAfee) for a media tour for the launch of the third year of the Tips campaign in 2014. Frieden and McAfee became concerned because Terrie seemed more tired and unsteady than before, but she insisted on persevering with the media tour. Unfortunately, a few weeks later she was diagnosed with metastatic cancer to her brain. As she rapidly declined, Terrie insisted McAfee and colleagues come and film her in the hospital “because I want young people to see what smoking does to you.” She convinced the hospital to allow a film crew to come to her bedside, where her final ads were filmed, just a few days before she died.
A national network of Quit lines
Another important element of the Tips campaign is that from the beginning there was a commitment to not only have the ads motivate people who smoke to try to quit, but also to ensure that every ad included an offer of help, reliably available for those wanting it. The Quitline network ensured that every person in the U.S. who wanted help quitting had access to free effective support simply by calling “1-800-QUITNOW” (archived here).
While there is a single national number, OSH provided support to develop and maintain a national network of state quitlines, with every state providing counseling support. This state-based network has worked now for 15 years. It is unique in the world for its combination of comprehensiveness, reliability, and facilitation of state autonomy with federal coordination and support. OSH elimination and loss of the NTCP state funding jeopardizes the ability of some states to continue providing meaningful quitline services, and possibly the national 1-800-QUITNOW number itself.
How do we know it worked?
Tips’ development and evolution has been guided continuously by research.
Following the first 3-month campaign, CDC conducted a longitudinal study that surveyed over 5,000 people before and after the campaign. Over 75% recalled seeing at least one ad on TV. More important, there was a 12% increase quit attempts, amounting to over 1.6 million additional smokers. This effect was confirmed in a large randomized dosing study during Tips’ second year.
As the Tips campaign continued, studies examined the cumulative impact of the campaign, including:
- From 2012-2018 Tips was associated with over 16 million additional quit attempts, and over a million sustained quits.
- From 2012-2018 Tips prevented 129,000 early deaths and saved $7.3 billion in smoking-related healthcare costs, with one early death prevented for every $3,800 spent on the campaign.
- Those exposed to more Tips ads who had quit smoking were less likely to relapse (odds ratio 0.63).
- From 2012-2023 Tips generated over 2 million calls to 1-800-QUITNOW. By calling, people nearly quadrupled (from 3.5% to 12.7%) their chance of quitting successfully.
- From economic perspectives (societal, all-payer, Medicare, Medicaid and private insurer) 10 years of Tips produced net savings ($10.4 billion for societal perspective).
What’s the Future?
Without a course change, Tips and 1-800-QUITNOW are not likely to survive because Trump and HHS Secretary Kennedy have shuttered OSH. The 18 Senators who wrote HHS Secretary Kennedy specifically asked about this, among other things.
Of course, none of Trump and Kennedy’s cuts even make any economic sense. The increase in medical costs next year caused by more smoking and tobacco use swamp any nominal savings to taxpayers. And reducing tobacco use remains the best evidence-based approach to preventing and reducing chronic disease, Secretary Kennedy’s stated priority.
The only winner is the tobacco industry.
It’s up to all of us to press to restore OSH and its programs as well as press the states to continue the progress they made in collaboration with OSH.
John Oliver put the gutting of OSH into context in his program on April 27, 2025:
Here is a summary of the Tips campaign that CDC OSH released shortly after it started that introduces several of the real people who appeared.
This information in this blog is based on material provided by Dr. Tim McAfee, who was director of OSH from 2010 to 2015, when the Tips campaign was developed, launched and evaluated. The “What’s the Future?” section is from me.
Stanton Glantz blog 