Along Hollywood’s famed Sunset Boulevard, one of the most enduring figures has been the 60-foot image of the ruggedly handsome cigarette pitchman for Philip Morris’s Marlboro brand. The Marlboro man, whose image of virility and independence helped make Marlboro one of the leading brands of cigarettes, is gone now. Well, sort of.

In April, the tobacco industry relinquished its outdoor advertising leases as part of the approximately $240 billion settlement with 46 states. The leases, which were paid in full, were turned over to the states, whose public health agencies are now posting antismoking messages on the same billboards where smoking was once promoted. The oft- photographed billboard on Sunset Boulevard was peeled away from its lofty perch on April 23 and replaced with a new version of the Marlboro man – an impotent smoker.

The giant cowboy still has a cigarette in his mouth, albeit a limp one. Underneath the picture of the Marlboro man look-alike reads the word "impotent" in big red letters, referring to smoking’s link to impotence.

"Everybody loves the impotence ads," said Stanton Glantz, PhD, a professor of medicine at the University of California San Francisco’s School of Medicine and a member of an advisory panel that approved California’s antismoking billboard ads. "It certainly has everyone talking. But how effective it is remains to be seen."

The Marlboro man is yielding to a new image in Iowa, as well. Designs borrowed from California’s campaign and unveiled by Iowa’s Department of Public Health and the Tobacco-Free Iowa coalition included two billboards featuring two Marlboro man-style cowboys. In the first billboard, one says to the other "Bob, I’ve got emphysema." In the second, the cowboy says, "I miss my lung, Bob."

"We thought the parody would get a message to the adult or young adult smoker," said Kevin Teale, communications director for Iowa’s Department of Public Health.

While parodies of the Marlboro man and similar icons may be funny, Dr. Glantz warns they can play into the hands of the tobacco industry by reinforcing an image of the industry already buried deep in America’s consciousness.

Also, parodies such as those in Iowa and California are delivering a health effects message, which traditionally have not been very useful in changing people’s habits. "Health effects messages can be delivered in the context of parodies and be effective, but they have to be part of a larger, well-sustained and well-designed campaign," Dr. Glantz said.

Both states are employing a series of tobacco ads in addition to their billboard campaign. From his sixth floor office, Teale can see one of the 14 billboards scattered across Des Moines that reads, "Kissing a smoker is like licking an ashtray."

"My 9-year-old thinks it’s gross, so it must be working," Teale said.

California, however, is taking a more aggressive tack. It has chosen to attack the tobacco industry with billboards advertising this message: "Are you choking on tobacco industry lies? Secondhand smoke kills."

To be effective, Dr. Glantz said, states must be willing to attack the tobacco industry. "States need to deliver three messages: that the tobacco industry lies, that nicotine is addictive, and that second-hand smoke kills."