The California tobacco control program known as Proposition 99 was established in 1989 using a portion of a twenty-five-cent increase in the cigarette tax. With an initial availability of more than $150 million, tobacco control was the state's single most important public health activity. Health and medical care programs also were supported by the tax. Despite sustained public support, the tobacco control component was weakened by political actions of the tobacco industry and also by the competing efforts of organized medicine and the lack of support from the executive and legislative branches of government. Nevertheless, Proposition 99 succeeded in reducing exposure to environmental tobacco smoke, cigarette consumption, and smoking prevalence among adults in California.