Graphic "Smoking Teens" Show

The images typically elicit a gasp or "ugh" from youngsters. Yet they can't help looking more closely at the "Iowa Smoking Teens," altered images of two teens that show the effects of smoking--from blackened lungs to a 20 percent increase in the risk of cataracts to "dead toes."

The innovative images of two teenagers, one male and one female, appear on life-sized cutouts and a poster (18" by 24") to illustrate how cigarette smoking and other nicotine use affects the human body, often causing disease. The visual materials are effective educational tools for the Thoracic Oncology Program within Holden Comprehensive Cancer Center at the University of Iowa. Online images allow viewers to click on each of the body parts or organs to learn more about the serious health risks associated with smoking cigarettes.

The posters target teens because 90 percent of people who smoke start by the time they are 18, said Renee Gould, A.P.N. with the UI Thoracic Oncology Program. The Centers for Disease Control and Prevention reports that one in three adult smokers began the habit at the young age of 14.

"Smoking is a pediatric disease," Gould said. "Unfortunately, our program doesn't see smokers until they're about 40 years old and have been smoking the majority of their lives."

Gould and colleagues take the life-sized cutouts and the posters to schools, state fairs, and health fairs. "If we can keep one person from smoking by showing these striking images, it's worth our visit," Gould said.

The images on the posters include photos (used with permission) of diseased organs and body parts from actual patients. For example, the "dead foot" that appears on the young man was taken from a patient who even volunteered to show the image to his granddaughter's class to help promote the non-smoking message. Nicotine use can result in poor circulation, causing tissue death in extremities like the toes.

Lou Halsch, former coordinator for the UI Thoracic Oncology Program, came up with the visual idea when she saw a life-sized cutout of Hayden Fry, former UI football coach, at a local grocery store. Previously, she had noticed that most anti-smoking visuals of tissue samples were too small for audiences to see and appreciate.

With the help of a UI pathologist and his library of specimens and the skills of a graphic designer, the group added the vivid images of diseased organs and body parts to the previously healthy appearance of life-sized models, two seniors at Iowa City West High School.

"I thought it would really be awesome to make a life-sized teen. Then, they were so popular, and people were asking how to get them, so we reduced the image size and put it onto a poster," said Halsch, who now works in graduate medical education for UI Hospitals and Clinics.

Halsch said that it is not necessarily the cancer aspects of the realistic images that make kids "sit up and take notice."

"Guys really pay attention to the photo showing impotence from nicotine use," Halsch said. "For other kids, it's the premature wrinkling, change in voice quality or staining on fingers that makes an impression on them."

The posters are used by teachers in their classrooms and, at fairs, grabbed up by a range of people--from grandmothers to college students who take them home to show their loved ones or roommates who smoke. The posters also have the positive effect of getting some teens interested in the health care profession, Halsch added.