USA TODAY - She's back. The woman with the deep, throaty rasp will again appear in graphic ads to warn about the reason she lost her real voice: smoking.
Terrie Hall, 52, who began lighting up as a pretty, 17-year-old cheerleader to fit in with friends, was up to two packs a day by the time she was 40 and diagnosed with throat cancer. Her larynx was removed, and she speaks via a hands-free device through a hole or stoma in her neck.
"My grandson has never heard my real voice," she says of the 11-year-old boy. "I don't even remember what my own voice sounds like."
Hall, who appeared last year in the U.S. government's first paid anti-smoking ads, attracted so much public attention (her spot got 1.3 million You Tube views) that she appears in the campaign's second 12-week phase, which launches Monday.
In ads that are just as in-your-face as the prior ones, Hall and other former smokers describe how smoking caused them to lose a parent at a young age or a leg from amputation or the ability to breathe easily. Nathan, 54, an Oglala Sioux from Idaho who often uses a respirator, says he got asthma from secondhand smoke exposure at work and lost his job.
Bill, a 40-year-old with diabetes whose smoking led to heart surgery, kidney failure and blindness in one eye, offers this tip: "Make a list. Put the people you love at the top. Put down your eyes, your legs, your kidneys and your heart. Now cross off all the things you're OK with losing because you'd rather smoke."
In her new TV spot, Hall's electrolarynx or speaking device makes a clicking sound and pops in and out of the hole in her neck every time she speaks. What she doesn't say is that she began smoking, like most people, as a teenager.
"I felt I was being left out, because I didn't do what they did. I didn't smoke. I didn't hang out," Hall recalls of her high school years in an interview at USA TODAY headquarters in McLean, Va. Because she was an athlete, she says, she wasn't allowed in the designated smoking area, "I snuck in there anyway to be with my friends," she says. "Today, I'm not friends with any of those people."
Although the friendships didn't stick, cancer did. She has been diagnosed 12 times with different types, mostly head, neck and lung. She lost her upper palette as well as her teeth and voice box. She now wears a wig, because she has been doing chemotherapy for three of every four weeks - for the past 30 months. "It's maintenance chemo," she says.
"These ads are literally lifesavers," says Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, which is running the ad campaign. He says the first phase, which ran for 12 weeks last spring, more than doubled calls to CDC's national toll-free quit line: 800-QUIT-NOW.
Frieden, a doctor who has treated many smokers, says the campaign's cost - nearly $50 million this year and $54 million last year - is less than "what the tobacco industry spends in three days" to market its products. He says smoking remains the leading U.S. cause of preventable death and disease, killing more than 443,000 Americans each year, causing 20 times as many to suffer serious illness and costing an extra $100 million in annual health care
He says the ads work while they're running, because "these are real people with real stories." Unfortunately, he says, their impact doesn't last. After the ads ended last year, he says, calls to the quit line dropped again.
The CDC knows the ads' graphic nature disturbs some viewers, so it's trying to protect young children from seeing them. "We're not running ads on the Disney Channel," says Tim McAfee, a doctor who has researched tobacco's toll and runs CDC's Office on Smoking and Health. "I think of it as immunization. I didn't like to give shots to kids. But it's a lot less than what Terrie has to go through."
Hall, who's listening to McAfee, nods. "It's reality," says the Lexington, N.C., resident. "When I was 13, I wish I had someone like me" to warn against smoking. Hall says she now regularly talks at high schools, finding the teens react most when she shows them her stoma.
She knows how difficult it is to quit, even though - beginning at age 25 - she had a sore throat that never went away. She says she quit when pregnant with her daughter, now 32, but then relapsed. She even smoked during her radiation treatments for oral cancer in 2001. It was only after the surgery to remove her voice box that she finally quit, cold turkey.
"I went into my bedroom, picked up a cigarette and lit it, then I looked at myself in the mirror. I saw what I was doing and realized what a fool I was," she said in a CDC chat on Facebook in September.
"I may not prevent other people from dying, but maybe I can prevent them from going through what I've gone through, what I'm still going through," Hall says. "I let them know they're not alone."