The U.S. Centers for Disease Control and Prevention has launched a $54-million U.S. television advertising campaign aimed at shocking smokers into quitting.

Dismayed that tobacco taxes and smoking bans haven't budged the U.S. smoking rate in years, the U.S. government has embarked on the graphic nationwide campaign.

The billboards and print, radio and TV ads show people whose smoking resulted in heart surgery, a tracheotomy, lost limbs or paralysis. The campaign is the largest and starkest anti-smoking push by the CDC and its first national advertising effort.

The agency is hoping the spots, which begin Monday, will persuade as many as 50,000 Americans to stop smoking. "This is incredibly important. It's not every day we release something that will save thousands of lives," CDC Director Dr. Thomas Frieden said in a telephone interview.

That bold prediction is based on earlier research that found aggressive anti-smoking campaigns using hard-hitting images sometimes led to decreases in smoking. After decades of decline, the U.S. smoking rate has stalled at about 20 per cent in recent years.

Advocates say it's important to jolt a weary public that has been listening to government warnings about the dangers of smoking for nearly 50 years. "There is an urgent need for this media campaign," Matthew Myers, president of the Campaign for Tobacco-Free Kids, said in a statement.

The CDC was set to announce the three-month campaign on Thursday.

One of the print ads features Shawn Wright from Washington state who had a tracheotomy after being diagnosed with head and neck cancer four years ago. The ad shows the 50-year-old shaving, his razor moving down toward a red gaping hole at the base of his neck that he uses to speak and breathe.

For the ads, advertising firm Arnold Worldwide found Wright and about a dozen others who developed cancer or other health problems after smoking.

Federal health agencies have gradually embraced graphic anti-smoking imagery. Last year, the U.S. Food and Drug Administration approved nine images to be displayed on cigarette packages. Among them were a man exhaling cigarette smoke through a tracheotomy hole in his throat, and a diseased mouth with what appear to be cancerous lesions. Last month, a federal judge blocked the requirement that tobacco companies put the images on their packages, saying it was unconstitutional.

Graphic ads are meant to create an image so striking that smokers and would-be smokers will think of it whenever they have an urge to buy a pack of cigarettes, said Glenn Leshner, a University of Missouri researcher who has studied the effectiveness of anti-smoking ads.

Leshner and his colleagues found that some ads are so disturbing that people reacted by turning away from the message rather than listening. So while spots can shock viewers into paying attention, they also have to encourage people that quitting is possible, he said.