The British Heart Foundation has pledged not to tone down the TV adverts it is producing on behalf of the Government, despite topping the Advertising Standards Authority's list of complaints in 2002.
The charity's image of a woman with a plastic bag over her head attracted 315 complaints, 27 more than a Pot Noodle campaign with the slogan 'Hurt me, you slag'.
The foundation's advert, which was created to show the respiratory effects of heart failure, was branded "irresponsible" by the advertising watchdog when it was released in June last year.
Since then the BHF has been chosen by the Government, along with Cancer Research UK, to produce a £15 million anti-smoking initiative.
Betty McBride, director of marketing and communications at the foundation, promised there would be no softening of the message. "It will be hard hitting: our brief is to be hard hitting," she said.
"I stand by last summer's campaign. You don't shock for the sake of shocking - you shock to move things forward. That's part of the role of a modern charity."
Donna Mitchell, press officer at the ASA, said: "Most advertisers say they didn't do anything wrong, but the fact is 315 people wrote in to complain.
"We didn't say it was offensive or alarmist, but from a safety point of view it might encourage children to emulate it," she said.
"We've always given charities a bit more leeway in using stronger imagery because of the message they need to get across, but we can't give them carte blanche."
Since the adverts were printed, the foundation has changed advertising agencies from Abbot Mead Vickers BBDO to Partners BDDH. But McBride denied this was because of the controversy. "We needed a fresh approach," she said.
The charity is expected to unveil details of the Government campaign this week. When Labour announced last year it was funding the voluntary sector to produce its anti-smoking advertisements, the BHF and Cancer Research UK were expected to collaborate.
But the charities have decided to work on separate campaigns, with BHF adverts expected to broadcast first in late summer.
Cancer Research UK's adverts, which are likely to follow in the autumn, are expected be equally controversial.
- See Leader, p17.