The driver's attention is diverted by texting, causing an accident that plays out in gory, throat-grabbing detail.
Media watchers said ads like this one being aired by /*AAA*/ of the Carolinas is one of the most effective of its kind.
"I think teens are used to seeing shocking scenes and accidents and you know they want to laugh at it or tune it out," said Barbara Lippert of Adweek Media. "The brilliance of this ad is it doesn't stop there."
The shock ads are intended, as your grandmother might say, to put "the fear of God into you."
There is even one pushing people to cut back on soda that shows a man drinking fat.
Another is a brutal domestic violence ad featuring actress Keira Knightly.
And then there's one from New York's campaign for smokers to quit, which shows a surgeon squeezing fat deposits from the arteries of a smoker. Another one gives audiences a look straight into the cancerous lung of a smoker.
"They're hard-hitting ads," said Jeffery Willet with the New York State Health Department. "We refer to them as high-sensation ads designed to unsettle people, but also to help smokers quit smoking."