It seems that there is the element of fear in that ad. Losing a hand would be devastating to young and old, alike. Psychologically, it seems to show how absurd it would be to continue smoking even with an amputated hand. Losing a hand would mean a huge disability no matter what the age of the person is. Think of all of the reasons having a hand is so important in terms of career, day to day activities, education, sports and being independent in general. Traditionally, most non-smoking campaigns target the lungs and show how the lungs look in a smoker's chest. This seems to be a different route to illustrate the negative effects that smoking cigarettes can have on a person's health.