NEW YORK -- Government health officials launched the second round of a graphic ad campaign Thursday that is designed to get smokers off tobacco, saying they believe the last effort convinced tens of thousands to quit.

The ads feature sad, real-life stories: There is Terrie, a North Carolina woman who lost her voice box. Bill, a diabetic smoker from Michigan who lost his leg. And Aden, a 7-year-old boy from New York, who has asthma attacks from secondhand smoke.

"Most smokers want to quit. These ads encourage them to try," said Dr. Tom Frieden, director of the Centers for Disease Control and Prevention.

The CDC campaign cost $48 million and includes TV, radio and online spots as well as print ads and billboards.

The spending comes as the agency is facing a tough budget squeeze, but officials say the ads should more than pay for themselves by averting future medical costs to society. Smoking is the leading cause of preventable illness and death in the United States. It's responsible for the majority of the nation's lung cancer deaths and is a deadly factor in heart attacks and a variety of other illnesses.

Last year's similar $54 million campaign was the agency's first and largest national advertising effort. The government deemed it a success: That campaign triggered an increase of 200,000 calls to quit lines. The CDC believes that likely prompted tens of thousands of smokers to quit based on calculations that a certain percentage of callers do actually stop.

Like last year, the current 16-week campaign spotlights real people who were hurt and disfigured by smoking. Terrie Hall, a 52-year-old throat cancer survivor makes a repeat performance. She had her voice box removed about a dozen years ago.

In last year's ad there's a photo of her as a youthful high school cheerleader. Then she is seen more recently putting on a wig, inserting false teeth and covering the hole in her neck with a scarf. It was, by far, the campaign's most popular spot, as judged by YouTube viewings and Web clicks.

In a new ad, Hall addresses the camera, speaking with the buzzing sound of her electrolarynx. She advises smokers to make a video of themselves now, reading a children's book or singing a lullaby. "I wish I had. The only voice my grandson's ever heard is this one," her electric voice growls.

One difference from last year: The new campaign tilts more toward the impact smokers have on others. One ad features a Kentucky high school student who suffers asthma attacks from being around cigarette smoke. Another has a Louisiana woman who was 16 when her mother died from smoking-related causes.

The return of the campaign is already being applauded by some anti-smoking advocates, who say tobacco companies spend more on tobacco product promotion in a week than the CDC spends in a year.

After decades of decline, the adult smoking rate has stalled at roughly 20 percent in recent years. Advocates say the campaign provides a necessary jolt to a weary public that has been listening to government warnings about the dangers of smoking for nearly 50 years.

"There is an urgent need to continue this campaign," said Matthew Myers, president of the Campaign for Tobacco-Free Kids, in a statement.

It would seem like a bad time for the CDC to be buying air time - the agency is facing roughly $300 million in budget cuts as part of the government's sequestration cuts in federal spending. However, the ad money comes not from the CDC's regular budget but from a special $1 billion public health fund set up years ago through the Affordable Care Act. The fund has set aside more than $80 million for CDC smoking prevention work.

Frieden argues that the ads are extremely cost-effective - spending about $50 million a year to save potentially tens of thousands of lives.

"We're trying to figure out how to have more impact with less resources," he said.

The ads direct people to call 1-800-QUIT-NOW. PlowShare Group, of Stamford, Conn., is again the advertising company that put the ads together.

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Online:

CDC campaign: http://www.cdc.gov/tips

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