Gutkha, an indigenous form of tobacco, has become a fixture in the mouths of millions of Indians (including 5 million children). With 80,000 cases of oral cancer annually, and most users oblivious to the fatal hazards of gutkha, Cancer Patients Aid Association wanted to make people aware of the silent killer.

1. A majority of the gutkha consumers are illiterate. So the design had to be simple enough to be understood by them.2. Many gutkha consumers were not aware that tobacco can cause cancer.3. Thirdly, the message had to be in the right place.4. The design also had to be feasible with a low budget.

The visually scary images of people puking blood worked effectively in warning users that the same might happen to them if they don't stop chewing gutkha. Many uneducated Indians weren't even aware of the harmful effects as they thought chewing gutkha was like chewing candy. By spending merely Rs. 1,50,000 ($3,000), the campaign got visibility in over 18 towns across the country.Within just 2 months, over 15,00,000 users came to know about gutkha-the silent killer.

After gutkha is consumed, it is usually spat onto a wall, causing an unsightly red stain. We created graffiti around them that looked as if the gutkha user was vomiting blood (a symptom of cancer). The stark visuals were easily understood by the semi-literate users. The design was budget friendly. Half the paraphernalia (the stains) was already available for free. We distributed stencils and spray cans to art students and asked them to spread the message. Since users came anyway to spit their leftover tobacco in their habitual places, they could not escape the message.