Researchers at the University of Massachusetts found that the smoking rates in Massachusetts are well below the national average. "The smoking prevalence among adults over 18 in Massachusetts is now about 19 or 20 percent, while the smoking prevalence for 40 other states is about 24 percent," said study author Lois Biener.

According to the study, Massachusetts spends $6.50 per-capita on tobacco control, more than any place in the world. The state's anti-smoking campaign includes forceful advertisements, treatment programs, counseling programs and educational materials.

"We've shown that a televised anti-smoking campaign has been very effective with youth, especially younger kids who were 12 or 13 at the start" said Biener. "When you look at peoples' reactions to individual ads, the ads evoking negative emotions like fear or sadness, or that tend to portray real individuals who have suffered illness, a lost loved one, or that graphically portray the effect of smoking, were the most effective. Ads that try to be funny or reassuring are less effective."

The study is published in the British Medical Journal.

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