Images with throat cancer, mouth cancer, gum disease, or lung cancer, massages like “Cigarettes Area Eating You Alive,” all printed on 400,000 matchbooks, are part of the aggressive “Eating You Alive” advertising campaign launched by the New York City’s Department of Health and Mental Hygiene. The matchbooks are distributed free at 132 cigarette retailers in the South Bronx, central and East Harlem and central Brooklyn.

Assistant Commissioner Sarah Perl says the effort is a counterpart to the billion dollars the tobacco industry spends each year promoting smoking by showing “glamorous, healthful images.” Tobacco advertisements are partly to blame for the rising rate of tobacco addiction.

“The reality of smoking is ugly and devastating. We hope these images will encourage New Yorkers to get the help they need to quit,” Perl said.

Health Commissioner Thomas Frieden said the scary matchbooks were designed to make smokers think twice before they decide to smoke their cigarette because it could mean a step forward on the road to throat cancer, gum disease, blackened lungs. “Many countries put these images right on the cigarette pack, where they belong. While the U.S. hasn’t done this yet — and New York City is pre-empted from requiring cigarette package labels — we are putting these images where New Yorkers buy cigarettes, just before they light up, in the hope they’ll think twice about the decision to continue smoking,” Frieden said in a statement. Countries including Australia, Brazil, Canada, Chile and Thailand have tried to show the negative effects of smoking through similar campaigns.

The consequences are well-known. Smoking increases the risk of heart attack, stroke and other medical problems. Studies found that people who smoke more than 20 cigarettes a day develop Alzheimer’s disease six to seven years earlier than those who don’t smoke. Drinking and smoking are two of the most important risk factors for Alzheimer’s disease.

Public bans on smoking improve the overall health of people, studies show. Researchers found that after a ban smoking in enclosed public place was introduced in Scotland in March 2006, there was a 17 percent reduction in hospital admissions for acute coronary syndrome. There was a 14 percent reduction in admissions among smokers, a 19 percent reduction among former smokers, and a 21 percent reduction among people who’d never smoked.

Previous efforts in the city’s two-year-old campaign to get New Yorkers think twice about smoking included cigarette taxes, given out free patches and gum for those who decided to quit smoking, and distribute several graphic advertising series that feature images of injuries generally related to cigarette smoking.

A report issued by the Centers for Disease Control and Prevention showed that New York City’s smoking rate has plummeted since anti-smoking measures were adopted in 2002. In 2002 New York City increased the tobacco tax, eliminated smoking in virtually all workplaces, and launched hard-hitting anti-tobacco ads.

Although smoking rates in the New York City have continued to decline, “there’s a lot more that the federal government should do,” said the commissioner, Dr. Thomas Frieden. Tobacco use is the number one preventable cause of death in the United States, with diseases related to tobacco killing more than 400,000 people each year.