Shock advertising is an age-old gimmick. But compared with milder fare from years past (“This is your brain on drugs”), today’s imagery is “like a sledgehammer to the face,” says Steve Hall, founder of the industry blog AdRants. For instance: the ad displayed above—an anti-drunk-driving spot for Arrive Alive—featuring a scantily clad girl collapsed in a men’s bathroom. Experts have called it muddled and pointlessly provocative.

Still, deterrence by disgust can work. In 2006, a series of Volkswagen safety ads drew attention for showing its cars in heart-stopping traffic accidents; within weeks, sales inquiries were up. A more recent ad for Canadian workplace safety features a glowing young chef describing her fiancé, whom she’ll never marry, she says, because she’s about to be in a “terrible accident.” She then slips and scorches her face with a cauldron of boiling water. The series of ads, all based on real accidents, has collected 1.7 million YouTube views. “Some small amount of discomfort is worth it if it creates positive change,” says Gary Mueller, founder of Serve, the agency behind the statutory-rape ads. The small discomfort, though, is getting bigger.