BY MOST accounts, political and public health leaders of California should be proudly blowing their horns over the success of the state's widely acclaimed antitobacco campaign, which some are calling "the most successful public health intervention since the invention of sewers." In 1988, the voters of California overwhelmingly passed Proposition 99 (known as Prop 99), which raised the state cigarette tax 25 cents a pack to fund a comprehensive tobacco control program. Since then, smoking prevalence has fallen nearly three times faster in California than in the rest of the nation. California's Tobacco Control Program is credited with reducing the number of smokers by 1 million and the number of cigarettes smoked by 1.1 billion packs. In addition, the California Department of Health Services estimates that the state saved more than $386 million in health care costs for treating tobacco-related diseases in 1993 alone. However, the horns that are blowing—in
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Andrew A. Skolnick (1994) studied this question.