I remember this campaign being discussed in a few journals back when it first came out. Yeah, there is a segment for whom the imagery has exactly the opposite effect. :)

Following up on the emotions that it provokes (rather than just the strict metaphor) leads to another problem with this campaign. It's intended for viewing by a wide audience. For the heterosexual male smokers who view it, I can't help but think that they feel some kind of homophobic response to it as they place themselves in the submissive role as designed in the image. I'm not sure that I want "I'M NO FAG!" being part of an anti-smoking campaign. It seems like a willingness to toss some people under the proverbial bus in favor of saving other people.

That interpretation is a small stretch, but not a huge one.