Debbie Austin smoked three packs a day for 20 years.
She was diagnosed with larynx cancer at age 42. As a result, she now has a stoma, or a hole, in her throat.
"I am the worst case scenario that your mother told you about," Austin said. "I am the walking dead."
Austin quit 14 years ago, about the same time the DPH released its first anti-tobacco advertisement campaign featuring Austin.
In one TV commercial, Austin pleads to the viewer to learn from her mistake. The hole in her throat is prominently displayed.
Since the campaign launched, smoking rates have dropped to an all-time low, but health officials said numbers are still high.
"We are still having 13 percent of the population smoking," said Dr. Mark Horton of the DPH. "That's still millions of individuals here in California that are smoking."
Studies show that Californians in rural areas smoke much more than those in big cities. Additionally, more men smoke than women.
If people don't care about their bodies, health advocates hope they'll care about the environment.
The DPH said 360 billion cigarettes are smoked every year in the U.S. That leads to 136 million pounds of discarded cigarette butts, which are made of a plastic that doesn't bio degrade.
"Every one of those pieces of cigarette trash contains probably over 400 chemicals that are known to be toxic," Horton said.
Since the passage of Proposition 99 in 1988, which imposed a 25 cent per pack state tax on the sale of cigarettes within California, adult smoking has decreased about 42 percent from 1988 to 2009.