California Department of Health Services, Tobacco Control Section

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California Department of Health Services, Tobacco Control Section

ANTITOBACCO CAMPAIGN
TOBACCO CONTROL SECTION MEDIA CAMPAIGN

MS 7206
PO Box 997413
Sacramento, California 95899-7413
USA
Telephone: (916) 449-5000
Web site: www.dhs.ca.gov/tobacco

ANTITOBACCO CAMPAIGN

OVERVIEW

For decades tobacco manufacturers had glamorized smoking through widespread marketing campaigns and promotions, but as the negative health effects of such behavior grew increasingly clear toward the end of the twentieth century, health officials in the United States sought to educate the public about the ills of tobacco. California was the first to organize a statewide advertising and education effort, one that was funded by smokers themselves through a state-legislated cigarette tax. Between 1989, when the campaign first began, and 1997, California spent almost $116 million on antitobacco advertising. Although this was a significant amount, it paled in comparison to the ad budgets of leading tobacco makers, which spent several billion dollars a year on advertising.

In 1997 the California Department of Health Services (CDHS) stepped up its efforts in the antitobacco battle by launching an estimated $67 million, three-year advertising campaign designed to reduce and prevent smoking among youths and adults. The aggressive campaign, developed by Asher & Partners (Asher/Gould Advertising, Inc., until late 1997) of Los Angeles, consisted of television, radio, and print advertising, including billboard ads. Ads geared toward minorities and specific ethnic groups were also included in the campaign. These were created by specialty agencies Imada Wong Communications Group Inc., Valdes Zacky and Associates Inc., and Carol H. Williams Advertising.

The following year, in June 1998, the second phase of the three-year effort was launched. The approximately $22 million campaign again consisted of an extensive series of print, television, and radio ads that focused on bringing to light the manipulative marketing practices of the tobacco industry, the dangers of secondhand smoke, and the link between smoking and impotency. This last topic was the focus of one of the best-known television spots of the campaign, "Gala Event," which suggested to the male audience that smoking could adversely affect their sex lives. The campaign also focused on the increasing popularity of cigars and on the smoke-free bar and restaurant policy that was implemented in the state at the beginning of 1998. Kim Belsh, the director of California's DHS, explained the overall goal of the campaign in an interview with Daniel Zwerdling of National Public Radio, stating that "the whole focus of our media campaign is really to de-normalize tobacco use. And de-normalizing tobacco use means changing the perception of tobacco from something that is viewed as acceptable and even glamorous to a more realistic perception of tobacco as dangerous, addictive, and socially unacceptable."

HISTORICAL CONTEXT

In 1998 California voters passed Proposition 99, an initiative that increased the tax on tobacco by 25 cents per pack of cigarettes, with the revenue to be used to fund antitobacco programs and healthcare services for underprivileged residents. In that year about 26.7 percent of Californians were smokers. The percentage declined rapidly as the tax-funded media effort began churning out aggressive advertising, and by 1995 only 16.7 percent of Californians smoked. The rate began to rise, however, when the administration of California governor Pete Wilson diverted $67 million in antitobacco funds in 1994 to pay for failing healthcare projects. In addition, television spots with an anti-industry tone, including one that featured tobacco industry executives testifying before the U.S. Congress that nicotine was not addictive, were discontinued because of pressure from the tobacco industry. Although antitobacco efforts continued, they were toned down both in character and in number, and in 1996, 18.6 percent of California adults smoked. The change in advertising, reported a research team from the University of California at San Francisco, led to an increase in tobacco sales between 1994 and 1998 of more than $1 billion, or an additional 840 million packs of cigarettes. Also alarming were statistics for young smokers. In 1992, according to the DHS, 8.7 percent of Californians aged 12 to 17 smoked. In 1995 the percentage was up to 11.9 percent. A survey conducted by the tobacco research center at the University of California at San Diego found that the percentage of youths aged 17 who were addicted to cigarettes had risen from 9.9 percent in 1993 to 12 percent three years later.

The increase in the number of California smokers, though considerably less than the national population of adult smokers, which hovered around 25 percent, was still cause for alarm among antitobacco activists, and many criticized the Wilson administration. Alan C. Henderson of the American Cancer Society of California said in the Los Angeles Times, "The Legislature and the governor need to wake up and smell the secondhand smoke. This is an embarrassment to the state that has been the leader in fighting tobacco." In response, the Wilson administration established a three-year contract with Asher & Partners to produce a major media campaign. In 1997, after some delays, the CDHS launched its first new advertising campaign since 1995 as a part of plans to reinvigorate the fight against tobacco. Sandra Smoley, secretary of California's Health and Welfare Agency, announced in a press release, "This advertising is some of the most aggressive, hard-hitting material that California's tobacco education media campaign has ever produced … These ads prove, once and for all, that this Administration is wholly committed to the anti-tobacco cause."

TARGET MARKET

The CDHS aimed its antitobacco advertising toward a number of audiences, but the agency primarily hoped to sway youths, including those who smoked and those who were susceptible to starting. More than 100,000 youths, a study at the University of California at San Diego discovered, took up smoking each year, and one-third of them would die from smoking-related diseases such as heart disease, cancer, or emphysema. Other studies indicated that it would take most of the addicted youths 16 to 20 years to quit smoking, and that almost 90 percent of smokers picked up the habit before reaching the age of 18. If youths made it past 18 without smoking, chances were high that they would not start. The studies made it glaringly clear to the CDHS that it was necessary to try to prevent teen smoking.

To effectively address youths, who often felt invincible and were not easily persuaded by advertising, it was important, researchers found, to inform them that the tobacco industry was trying to control them. One 1997 ad, "Voicebox Smoker," featured Debi Austin, a woman who began smoking at the age of 13. The spot, shot when she was 46, showed a hole in her throat where her larynx had been cut out because of her smoking habit. Still, Austin had not quit smoking; she smoked through the hole. She explained in the commercial, "When I found out how bad smoking was, I tried to stop. Believe me. I wish I could. But I can't." Belsh, discussed the strategy behind the ad in USA Today, saying, "You need to push emotional buttons … You need to give kids real evidence that they're being manipulated by the tobacco industry."

The CDHS targeted adult smokers with its media campaign as well, with ads focusing not only on the harm inflicted upon the smoker but also on the damage caused to loved ones and others through secondhand smoke. For the 1998 campaign the CDHS tackled two new issues. Because all California bars and taverns became smoke-free at the beginning of 1998, ads were deemed necessary to convince disgruntled smokers that this was a positive policy. Another issue the CDHS hoped to spotlight was the link between smoking and impotence. This time the focus was on men between 18 and 30, an age group that had traditionally been resistant to altering smoking habits. As Belsh, explained in the Toronto Globe and Mail, "Our experience has demonstrated that warning these guys that smoking will affect their health later in life has not been a very effective inducement to quit … Maybe warning them about the effects on their sex lives will be more powerful." The problem was not one to be taken lightly, for numerous studies, including the Massachusetts Male Aging Study, had indicated a significant link between smoking and impotence.

COMPETITION

The most powerful adversary of the CDHS was the tobacco industry, which consisted of the biggest advertisers in the United States. Philip Morris Companies Inc., the parent company of number one tobacco maker Philip Morris U.S.A., was the third leading U.S. advertiser in 1996 and also in 1997, despite a 5 percent reduction in ad spending. Philip Morris U.S.A., which produced such brands as the top-selling Marlboro, Benson & Hedges, Virginia Slims, and Merit, supplied about half of all the nation's cigarette shipments. Others included R.J. Reynolds Tobacco Company and Brown & Williamson Tobacco Corp. These powerful companies boasted immense advertising coffers and held the advantage of history. Tobacco companies had advertised and marketed their products for decades before the 1970 ban on radio and television cigarette advertising, making a strong and lasting impression among the public. Antitobacco awareness, on the other hand, was still in its infancy.

MARKETING STRATEGY

The 1998 antitobacco media campaign developed by Asher & Partners consisted of several dozen television, radio, and print/billboard ads, including some borrowed from the Massachusetts Tobacco Control Program's media campaign. Although the dangers of smoking were by then common knowledge in the United States, antitobacco messages were still a hard sell. As Bruce Dundore of Asher & Partners admitted in Adweek, "It is a very challenging account … It's tough to get people not to buy stuff, especially when it's a product equated with pleasure."

STARS AND SMOKES

Not only did the California Department of Health Services and other antitobacco forces have to contend with competition from tobacco manufacturers, but they also battled Hollywood. Many blockbuster movies, including Reality Bites and My Best Friend's Wedding, featured chain-smoking characters, portrayed by Winona Ryder and Julia Roberts, respectively. First lady Hillary Rodham Clinton criticized the movie industry for its focus on smoking, with the Los Angeles Daily News quoted her as commenting on Roberts's character: "This portrayal of a modern woman so reliant on cigarettes is particularly troubling given that more young women are taking up the deadly habit."

Ads that publicized the implementation of California's smoke-free policy for restaurants and bars began running in late 1997, and radio and television spots addressing the increased popularity of cigars began to air in the spring of 1998 while the full campaign continued to be developed. The cigar effort centered on the theme "Cigars, the big new trend in cancer," and the single television spot "How Many?" focused on the amount of nicotine in each cigar. A business suit-clad character named Chad relaxed with a cigar as the narrator questioned him about how many cigarettes he thought might equal the nicotine of one cigar. As he offered guesses, the corresponding number of cigarettes appeared in Chad's mouth. The narrator finally informed Chad that he would need to smoke more than 70 cigarettes to equal the nicotine in the cigar, and 70 cigarettes were seen stuffed into Chad's mouth. The spot ended with the narrator asking, "Need a light, Chad?"

In June 1998 the full CDHS campaign was launched. "Gala Event," the television spot that emphasized the link between smoking and impotence, was set at a festive affair. A handsome man in a tuxedo caught the eye of a beautiful woman across the bar, and the two exchanged long gazes as he suavely lit a cigarette. His cigarette suddenly went limp, and the woman was gone. The voice-over explained, "Now that medical researchers believe cigarettes are a leading cause of impotence, you're going to be looking at smoking a little differently." The spot then focused on three men smoking cigarettes. An attractive woman sauntered by, and the three men stared after her, only to find their cigarettes going limp. Embarrassed, the men covered their cigarettes or removed them from their mouths. The narrator then asked, "Cigarettes. Still think they're sexy?" "For decades, the tobacco industry has tried to link its deadly products with virility and sex appeal," explained Belsh, of the CDHS. "It's ironic that medical science shows smoking to be one of the leading causes of male impotence."

"Baby Smokers" focused on the problems of secondhand smoke and showed photos of young children and infants with lines such as "Nicholas Steele. Smoking since birth" and "Chris McDonald. Pack-a-week smoker" superimposed on the photos to emphasize how a parent's or guardian's habits could directly affect children. The tag line read, "Secondhand smoke is a first-rate killer." "Waitresses" featured various waitresses from restaurants and bars explaining the health hazards they experienced as a result of working in smoke-filled environments. They also voiced their support of the smoke-free restaurants and bars policy. "Ironic Quotes" showed a bedridden patient named Aaron. After quoting a tobacco industry executive, who claimed that people did not die from smoking, Aaron stated, "Let me clear things up for him. My doctor says I have less than one year to live." The tag line read, "The Tobacco Industry—They can bury the victims, but they can't bury the truth." A print ad, "Truth vs. Advertising," featured a circle of 20 cigarette print ads—ads that focused on the glamorous aspects of smoking and led consumers to believe that their lives would be enhanced by cigarettes—with the dates they ran. Printed alongside the ads were messages revealing what tobacco companies knew about cigarettes, for example, "The tobacco industry has known that nicotine is addictive since 1963. They denied any knowledge before Congress in 1994. Four years later they finally admitted it."

OUTCOME

The 1998 antitobacco campaign received considerable media attention, particularly "Gala Event," which brought to light a traditionally taboo subject. The number of smokers in California appeared to be on the decline as well, with the percentage of adult smokers dropping from 18.6 percent in 1996 to 18.2 percent in 1997. Smoking among youths also dropped, from 11.2 percent in 1996 to 10.9 percent in 1997. "I'm encouraged by the decline in smoking," announced Belsh, in a press release. "Smoking among youth in California has dropped for two years in a row, despite rising rates of youth smoking around the rest of the country. The adult smoking rate remains lower than any other state, with the exception of Utah." Also encouraging was the reduction in illegal sales of tobacco goods to minors in California, which dropped to 13.1 percent in 1998, an impressive 40 percent in one year.

Although the CDHS continued with its aggressive antitobacco media campaign in 1999, the word about the ills of smoking began to spread beyond a few select states such as California, Massachusetts, and Arizona. Out of the $206 billion settlement reached between tobacco companies and 39 states, which were suing to recoup the healthcare costs generated by tobacco-related illnesses, about $1.45 billion was tagged to pay for a five-year national antitobacco educational campaign. The newly formed National Tobacco Control Foundation was thus poised to launch the largest and most unified antitobacco advertising campaign ever developed, with an estimated $150 to $225 million marketing budget for 1999.

TOBACCO CONTROL SECTION MEDIA CAMPAIGN

OVERVIEW

In 1988 California voters passed Proposition 99, a measure that imposed a tax hike on cigarettes and earmarked the revenues thereby generated for antismoking efforts, including statewide media campaigns. The Tobacco Control Section of the California Department of Health Services (CDHS) thus pioneered the high-profile, taxpayer-funded, big-budget antismoking advertising efforts that would ultimately become common across the United States. The California campaigns consistently attracted media attention and industry awards, but in 2000 CDHS decided on a change of course for its advertising. Hiring the Los Angeles-based agency Ground Zero, CDHS set itself the task of supplementing its ongoing educational, secondhand smoke, and cessation efforts with a more direct and confrontational assault on the integrity of tobacco companies and their personnel.

Budgeted at $125 million over five years, the Ground Zero work for CDHS first took the form of 2001 television spots as well as outdoor and print ads tagged, "Do you smell smoke?" The television spots featured a fictional tobacco executive named Ken Lane, who was shown disclosing despicable trade secrets in discussions with colleagues. In 2002 Ground Zero crafted a particularly powerful spot aimed at convincing current smokers to quit, and in 2004 the agency intro duced its "Undo" theme, which used images of people blowing bubbles instead of smoking, among other arresting visual schemes, as a way of asking Californians to imagine a world without cigarettes.

California continued to post decreases in its adult smoking rates throughout the years that the Ground Zero-crafted antitobacco campaigns ran, building on the declines that had been initiated beginning with Proposition 99. Only Utah boasted fewer smokers per capita among its adult population.

HISTORICAL CONTEXT

Beginning in 1967, the Federal Communications Commission required television broadcasters to donate airtime to one antitobacco advertiser for every four tobacco commercials that appeared. The antitobacco spots produced in subsequent years by groups such as the American Cancer Society proved extremely effective, and cigarette consumption in America began dropping for the first time in the twentieth century. Tobacco companies thus supported a ban on the television advertising of their own products, since such a move would largely spell the end of donated airtime for antitobacco groups, and since these groups would find it difficult to buy their own time or otherwise place public service spots during peak viewing hours. After the eventual Congressional ban on the television advertising of tobacco products was enacted, and through most of the 1970s and 1980s, antismoking commercials were generally relegated to off-peak hours and were not considered effective. Tobacco companies, meanwhile, devoted their extensive resources to other media and to high-profile sponsorships. The smoking declines initiated in the late 1960s slowed.

The economics of antitobacco advertising began to change dramatically, however, when California voters passed Proposition 99, the California Tobacco Health Protection Act of 1988. The act introduced a new statewide cigarette tax of 25 cents per pack and allocated the resultant revenues to a group of complementary anti-smoking initiatives, including education programs in California schools, funding for tobacco-related research, and a media campaign. Among the media campaign's early efforts were spots that pointed out the moral bankruptcy of the tobacco industry; for instance, one commercial showed individual industry executives testifying in a congressional hearing that they did not believe tobacco was addictive. The best-known work in the first decade of California's media campaign was crafted by the Los Angeles advertising agency Asher/Gould (successively renamed Asher & Partners, Asher/Gal & Partners, and Italia/Gal). Among the agency's most lauded campaigns was a 1997 series of billboards featuring two cowboys on horseback in imagery that recalled the famous "Marlboro Man" ads. "I miss my lung, Bob," read the text in one such billboard. "Bob, I've got emphysema," read the text in another.

The California antismoking campaign was the first of its kind and scale in the world, and its success inspired Massachusetts, Florida, and Arizona, among other U.S. states, to embark on similar taxpayer-funded campaigns. CDHS's approach to antitobacco advertising, as well as its larger strategy for the denormalization of tobacco use, likewise served as a model for such organizations as the Centers for Disease Control and the World Health Organization. Between 1988 and 1999 adult smoking rates in California fell more than 32 percent, and California's declines in teen smoking well outpaced declines in other states.

TARGET MARKET

CDHS's 2000–05 antismoking media campaigns ran statewide in California, with the bulk of the messaging and budget devoted to a general market but with supplemental, language- and/or culture-specific commercials designed for Asians and Pacific Islanders, Latinos, African-Americans, and American Indians. CDHS placed great emphasis, through educational programs and other facets of its overall antismoking strategy, on a teenage audience, noting that 88 percent of smokers were introduced to cigarettes before age 18 and that the tobacco industry subtly continued to target teenagers despite legal rulings ordering it to cease doing so. The media campaign did not appeal strictly to teenagers, however. Part of the state's overall antismoking strategy was to denormalize tobacco use in the culture at large, which would presumably, in both the short and long term, make the activity less appealing to impressionable youngsters. It was especially necessary to spread an antitobacco message to a general audience, CDHS felt, given the tobacco companies' own concurrent efforts at normalizing their corporate images through court-ordered public-service advertising as well as voluntary image-crafting efforts. Many of the Ground Zero-crafted spots created between 2000 and 2005 focused on showing that tobacco companies, far from being normal businesses, were in fact morally reprehensible, villainous entities. The campaign also featured spots aimed at current smokers, which, in an effort to encourage them to quit, employed hard-hitting dramatizations of the dire health risks they were taking by engaging in the habit.

COMPETITION

One of the first states to use the California model for battling the tobacco industry's influence was Massachusetts, whose Department of Health and Safety in 1994 increased taxes on cigarettes and invested the revenues in an ambitious marketing campaign crafted by the Boston advertising agency Houston Herstek Favat. Called "Truth," the campaign's television spots, like some of the early California commercials, sought to expose the tobacco companies' morally compromised business practices. Patrick Reynolds, a grandson of tobacco scion R.J. Reynolds, appeared in one spot providing information about the numerous harmful chemicals in cigarettes. "Why am I telling you this?" Reynolds asked. "I want my family to be on the right side for a change." Print ads attempted to generate public support for legislative measures aimed at reining in tobacco companies.

In 1998 the state of Florida likewise launched a marketing campaign funded by increased taxes on cigarettes. Created by Miami agency Crispin Porter + Bogusky and named "Truth" (like the Massachusetts campaign), the Florida campaign's highlights included spots pairing the congressional testimony of tobacco-industry executives with a sitcom laugh track, as well as spots showing teenagers who phoned tobacco corporations to ask pointed questions such as, "What is it about Lucky Strike cigarettes that's lucky? Is it that I might live?"

Following the 1998 master settlement agreement between four major tobacco companies and 46 U.S. states, which resolved lawsuits filed by state attorneys general, the tobacco companies were required to run their own antismoking advertising. Some critics, however, contended that these campaigns warned against smoking via methods that actually made smoking seem rebellious and therefore attractive to teens. Tobacco companies also took significant voluntary steps to recast their corporate images. Philip Morris Companies, for instance, changed its name to the comparatively nondescript Altria and markedly increased its food brand holdings.

TARGETING CHILDREN

In a website companion to its media campaign, http://www.tobaccofreeca.com, the California Department of Health Services detailed ways in which tobacco companies continued to target minors despite the laws prohibiting them from doing so. CDHS pointed out, for instance, that images of the Marlboro Man, an icon specifically created to appeal to young people, was still, as of 2004, prominently featured in Philip Morris's advertising. The website cited a 2001 Stanford University study finding that almost half of California's convenience stores had tobacco advertising materials placed at a height of three feet or lower, at eye level with young children, and that in 23 percent of the state's convenience stores, cigarettes for sale were located less than six inches away from candy displays. In 2002, CDHS reported, R.J. Reynolds was caught advertising in youth-oriented publications. And in 2003 the Tobacco Enforcement Committee of the National Association of Attorneys General discovered that four different tobacco corporations had run ads in school editions of major U.S. newsweeklies.

Another noteworthy result of the 1998 tobacco settlement was the formation of a public advocacy group with national reach, the American Legacy Foundation (ALF), funded by $1.5 billion of the total $206 billion in settlement money. Beginning in 2000 ALF spent more than $150 million a year on nationwide, antismoking advertising cocreated by Boston's Arnold Worldwide (which had merged with Houston Herstek Favat) and Crispin Porter + Bogusky. The two agencies, leveraging their combined experience on the Massachusetts and Florida campaigns, had formed a team called the Alliance to bid for the ALF account. Unprecedented in scope and budget resources compared to previous anti-smoking projects, this campaign was, like its Massachusetts and Florida predecessors, also called "Truth," and it went to previously unexplored inflammatory lengths. One of the Alliance's first efforts involved filming activist teens piling body bags outside Philip Morris's corporate headquarters in New York. The resulting spots proved too controversial for the major television networks and were pulled off the air, along with another commercial shot at Philip Morris headquarters, after the tobacco companies involved in the 1999 settlement publicly complained.

MARKETING STRATEGY

CDHS's August 2000 hiring of Ground Zero for a five-year, $125 million advertising effort represented a change of direction for the state's antismoking campaigns. Like the nationwide "Truth" campaign then getting under way, the Ground Zero work focused more intensely than ever on overt vilification of tobacco companies. The campaign's television spots broke in early 2001 and ran during prime-time network programming like CBS's Survivor season finale and the NBC shows ER and The West Wing. Supporting outdoor, print, and online work reinforced the tagline "Do you smell smoke?" which, as Ground Zero's chairman Jim Smith told Adweek, referred to the premise that "the tobacco companies use smoke and mirrors, and we're suggesting maybe you smell smoke, and there's no smoke without fire."

The "Do You Smell Smoke?" television spots provided a documentary-like, fly-on-the-wall look inside the offices of a fictional tobacco company and centered on an amoral executive named Ken Lane, who explained ways in which the tobacco industry duped consumers. In "Lights," Lane was shown expounding on the fallacious perception that light cigarettes were better than regular cigarettes for one's health, explaining the manufacturing details that supposedly reduced tar and nicotine but in actuality did not, and marveling at the effectiveness of industry advertising that spread this misconception. A print ad running under the same tagline meanwhile pointed out the tobacco companies' alleged targeting of children despite the fact that the practice had been outlawed. Showing a young boy standing at a convenience store counter surrounded by numerous tobacco advertisements and transfixed by a large image of the Marlboro man at eye level, the ad's copy read, "Kid: 45 inches" and "Poster: 45 inches."

Ground Zero supplemented the anti-industry advertising with work that addressed the dangers of second-hand smoke and work that encouraged cessation. One 2002 television spot promoted the latter objective with particular force. Called "Echo," the spot featured a series of young, healthy-looking smokers who gave common excuses for why they could not quit smoking. Each statement in turn was juxtaposed with a statement from an overtly suffering, but not noticeably older, former smoker. A young man opened the commercial by noting with a smile that he could not "go more than a few hours without a cigarette," and his statement was followed by that of an emaciated man with tubes in his nose grimly saying, "I can't go more than a few feet without the oxygen tank." Similarly a healthy woman explained that she tried to quit smoking but gave up because she gained five pounds; her speech gave way to that of a female cancer patient saying, near tears, "I've lost twenty-five pounds." The spot closed with on-screen text that said, "Quitting is hard. Not quitting is harder."

No strategic changes were made to Ground Zero's CDHS work until 2004, when the theme "Undo" was applied to the campaign's television, print, outdoor, and online advertising as a means of asking consumers to visualize a world without smoking. One television spot used the tagline "Undo tobacco everywhere" and images of people in commonplace smoking locations and positions who instead of smoking were blowing bubbles. Another spot, tagged "Undo the exploitation," returned to the theme of tobacco-executive villainy by equating excellence in the business with a willingness to exploit the most vulnerable of all possible targets, young children. Another 2004 spot, "Growth," showed tobacco executives in a conference room who began uncontrollably birthing clones from their chests until suit-wearing clones covered the city streets outside the company offices. The image of irrepressible growth intentionally conflated tobacco-industry market gains and cancer, an idea underscored by on-screen text reading, "The more they grow, the more we die."

OUTCOME

The 2001 Ken Lane commercials so effectively impugned the integrity of tobacco-industry executives that the tobacco companies R.J. Reynolds and Lorillard filed a lawsuit alleging, as Adweek reported, that the spots "violated their constitutional rights and had a prejudicial effect on potential jurors in lawsuits related to smoking." The lawsuit was ultimately rejected. "Echo" was voted one of Adweek's Best Spots of 2002. California's adult smoking rates remained lower than those in all other U.S. states except Utah: only 16.2 percent of the California population, as of 2003, were smokers, down from the 1988 rate of 22.8 percent. In 2004 the state's smoking rate reached a historic low of 15.4 percent, and state public health officer Dr. Richard J. Jackson announced, "Our messages about the dangers of tobacco use, secondhand smoke and the tobacco industry's misleading marketing practices are resonating with all Californians." Jackson further noted that California's smoking-related cancer rates were then declining three times faster than were rates among other Americans and declared that California would continue to spread its antitobacco message as long as tobacco products were sold.