From the moment the creepy message of “Only One Leaves” hits the screen in the latest anti-smoking spot for the FDA, viewers know they’re in for a different type of PSA—one that also happens to live within a video game.

Directed by Darren Aronofsky and cut by Lost Planet’s Ben Rodriguez, the FDA’s latest spot in their “The Real Cost” campaign works to illustrate the dangers of teen smoking and addiction by tapping into the tropes of horror films and creating a reality that is downright eerie—a reality that’s not unlike the effects of smoking.

Keenly aware of their teen audience, the spot has a video game tie-in for Xbox to further communicate the grave consequences of smoking. The game, created by FCB and titled “One Leaves,” is yet another modicum for showcasing the dangerous implications of smoking.

The scenes cut quickly as the teens flee from room to room, bringing viewers along for the ride—whether they like it or not—before ending on one teen’s escape from the undeniable horror of smoking.

Check out another FDA spot from Ben right here.