Dan Morain: Her message was loud, clear

As she fought for breath, she made more commercials, and spoke to students. She made more than one school administrator blanch with her salty language. She also left an impression. A young doctor introduced himself during one of her many hospital stays by saying he was inspired to go into medicine after seeing her talk when he was a kid.

"The worse I look, the more impact I have on my audience," she told a Contra Costa Times reporter in 2010. "If I walked in with a scarf over my neck, it wouldn't send home nearly the impact than if they saw it."

In 1988, when there were 28 million Californians, residents inhaled 2.5 billion packs of cigarettes a year. Now there are 39 million, and consumption has fallen to 970 million packs a year.

Only 12 percent of us smoke, a testament to good sense, the power of the state's social marketing, and angry activists such as Debi Austin.

California will spend $45 million on anti-tobacco efforts this year, less than half of the $95 million spent in 1989, the first year after voters approved the tax. Because of its success, the tobacco control unit is putting itself out of business. As smoking declines, tobacco tax revenue falls. But there's another reason. The tobacco industry is skilled at killing tobacco tax increases.

California's 87 cent per-pack tax on cigarettes places it 33rd among the 50 states. Texas, whose governor touts his state's low taxes, charges $1.41 per pack tax. Arizona charges $2 a pack.

Nevada's tax is lower than California's. But in Nevada, where more than 20 percent of the people smoke, women have the nation's second-

highest death rate from lung cancer. California was the only state where lung cancer deaths dropped among women from 2001 to 2005.

In their quest to generate revenue, legislators have introduced bills to raise taxes on bullets and soda. In an indication of the tobacco industry's clout, no legislator proposed a tobacco tax hike.

Bullet or soda taxes might have some social benefit. But tobacco taxes clearly lead to improved health. Experts know that smoking declines by 4 percent for every 10 percent increase in prices, which is why tobacco companies work hard to block tax hikes.

Health care advocates talk of trying to win a tobacco tax increase later this year. An extra $1.50 per pack tax would cut smoking significantly, particularly if some money is earmarked for anti-tobacco efforts. However, Republicans and some Democrats find common ground in their aversion to tobacco taxes.

The politics are clear. Since 2000, tobacco companies have spent $125 million on California campaigns. They spent $45 million last year, much of it to defeat an initiative to raise tobacco taxes.

Tobacco industry money gives it clout. But Austin was able to talk back, thanks to the $175,000 that California's tobacco control unit spent to produce "Voicebox." Austin wanted to stay alive until she had spoken to a million kids. She didn't think she reached that goal, her sister said. She was wrong. Doctors had removed her larynx. But she spoke to many millions. We couldn't stop watching.

Email: dmorain@sacbee.com or follow on Twitter: @danielmorain

THE SACRAMENTO BEE