The Media Campaign
In contrast to the complexities of getting the local programs off the ground, it was a relatively simple bureaucratic task to launch the anti-smoking media campaign that AB 75 had established. It merely required writing one request for proposals and issuing one contract to one advertising agency. It was the one way that DHS could show the public and politicians that it was doing something with Proposition 99 money in a hurry.
DHS moved quickly to implement the media campaign. The request for proposals was released on December 1, 1989, fifty-nine days after Governor Deukmejian had signed AB 75; responses from advertising agencies were due just six weeks later, on January 10, 1990. On January 26, DHS selected the Los Angeles advertising agency keye/donna/perlstein to run the campaign.[8] The first anti-tobacco advertisements reached California's television viewers on April 10, 1990, sixty-five days after the contract was signed.[9]
The campaign was like nothing the world had ever seen. Rather than talking about the dangers of smoking, or even secondhand smoke, the campaign directly and explicitly attacked the tobacco industry.
The first television advertisement, “Industry Spokesmen,” showed a group of actors portraying tobacco industry executives sitting around a smoke-filled room (figure 8). Their leader says:
Gentlemen, gentlemen. The tobacco industry has a very serious multi-billion-dollar problem. We need more cigarette smokers. Pure and simple. Every day, 2,000 Americans stop smoking and another 1,178 also quit. Actually, technically, they die.
That means that this business needs 3,000 fresh, new volunteers every day. So, forget all that cancer, heart disease, stroke stuff.
Gentlemen, we're not in this for our health.
At the end, he laughs, joined by the other executives.
This radical new approach grew out of discussions between Kizer, Dileep Bal, head of the Cancer Control Branch (which includes TCS), and ad agency principal Paul Keye, who brought a new perspective to the question of how to reduce tobacco consumption. As Keye later explained,
The cigarette companies were never in any of the advertising agency's original thoughts or conversations with the Department of Health Services. You can't find the topic in our first work. …What happened was that—as we dug into each topic—there, right in the middle of everything were the Smokefolk,
― 127 ―making their quaint, nonsensical arguments and—by sheer weight of wealth and power and privilege—getting away with it. …Frankly, the tobacco industry pissed us off. They insulted our intelligence.[10]
Figure 8. California's first anti-tobacco television advertisement, “Industry Spokesmen,” was a frontal attack on the tobacco industry. This advertisement set the tone for the California Tobacco Control Program when it was first aired in April 1990. (Courtesy California Department of Health Services)
Instead of falling back on the traditional public health messages (“tobacco is bad for you”), Keye urged that the campaign directly attack the tobacco industry. The first reaction to the campaign within TCS was surprise, with some wondering aloud, “Can we say that?” But TCS soon agreed that it could and should, and the anti-industry emphasis became an integral part of the campaign.[10][11] TCS was out to raise the temperature around tobacco as an issue, convincing people that smoking was not normal, ordinary behavior and the tobacco industry was not just another legal business.
To reinforce this message and to announce the new aggressive campaign against the tobacco industry, TCS ran full-page advertisements in all the major newspaper in California on April 11, 1990, with the headline “First, the Smoke. Now, the Mirrors”(figure 9). The text began:
In less than a generation, the bad news about cigarettes has become no news. Most Americans—even the very young—know the unavoidable connection
― 128 ―― 129 ―between smoking and cancer, smoking and heart disease, smoking and emphysema and strokes.Today a surprising number of us can tell you that cigarettes are our #1 preventable cause of death and disability.
So, we seem to know about the smoke. But what about the really dangerous stuff—all those carefully polished, fatal illusions the tobacco industry has crafted to mess with our minds so they can mess with our lives?[12]
Figure 9. California's first anti-tobacco newspaper advertisement. The Department of Health Services announced the new California Tobacco Control Program with this full-page advertisement in newspapers throughout the state on April 11, 1990. (Courtesy California Department of Health Services)
Smoking was not just a health problem; it was also a social and political one.
The tobacco industry and its allies in the advertising industry went wild. Walker Merryman, vice president for communications at the Tobacco Institute in Washington, protested that “the ads themselves have broken faith with the voters. …They are an unsavory assault on tobacco companies.” He claimed that they were not educational advertisements.[13] Tom Lauria, a spokesman for the Tobacco Institute, agreed: “They pitched Prop 99 as: `We want to reach underaged children. We want to educate children to the purported health effects of smoking.'…anything beyond that is not educational, it's political.”[14] Bob Garfield, a columnist in Advertising Age, an advertising industry trade newspaper, accused TCS of inciting racial paranoia by trading on “a vile stereotype: the wealthy, white embodiment of evil. …This `public service' message is inflammatory and racist and it will feed paranoia. …Californians should indeed be careful of what they breathe. There is something foul on their air.”[15]
Governor Deukmejian was cool toward the advertisements. One of his spokesmen explained: “It's not in the nature of the governor to go on an attack like this. He's always been genteel and civilized in his approach to public affairs.”[16] Deukmejian, however, took a hands-off approach to the campaign and allowed Kizer and DHS to proceed according to their professional judgment. Indeed, the Tobacco Institute lamented the way Governor Deukmejian was giving Kizer free rein over the campaign: “As a `lame duck,' the Governor is not likely to get into a public sparring match with Dr. Kizer, even though he disagrees with the Department of Health Services' attack approach with the anti-tobacco advertisements.”[17] Rather than submitting the detailed, multilayer political review of the media campaign that came to be required when Pete Wilson succeeded Deukmejian as governor, TCS simply made a “brown bag run” to the Governor's Office the night before new ads were aired so that the governor would know what was about to hit.
The other first-wave advertisements in 1990 were just as strong. One featured black rappers attacking the tobacco industry for targeting African Americans with mentholated cigarettes, using the tag line “We used to pick it; now they want us to smoke it.”[13] Another showed a husband and his pregnant wife sitting together. When the man lights up and inhales deeply, the smoke comes out the woman's mouth. The tag line was “Smokers aren't the only ones who smoke.”[15]
The advertisements attracted international attention. Indeed, in 1997, seven years after it had originally run and over a year after Governor Pete Wilson's administration had ordered it off the air permanently, “Industry Spokesmen” still had the highest recall rate—96 percent of adults and 93 percent of teens—of any advertisement that DHS produced.[18] The advertisements stimulated strong public interest in the Tobacco Control Program. They also set the overall tone for the program as one that considered tobacco a social and political problem well beyond the bounds of traditional public health thinking at the time.