Decades after his career as a tobacco advertising icon, Bryan Burns’ life is in ruins. After his mother dies of lung cancer, he is tormented by a talking cigarette on an anti-smoking billboard. He snaps and transforms into the Ribspreader, a killer stalking the city, extinguishing smokers and cutting out their lungs to make his macabre smoking jacket.

After the death of his girlfriend, Travis, a thirty-something psychiatrist, struggles to keep it together. On the brink of a nervous breakdown he stumbles across a strange church run by a charismatic leader, Pastor Jay. In search of answers Travis is led deeper and deeper into the underworld of religious fanaticism, home to a Doomsday cult and a teenage girl named Grace.