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OCR for page 355
Ending the Tobacco Problem: A Blueprint for the Nation
Index
A
Abt Associates Inc., 165, 169, 170
Access to tobacco products
adolescent perceptions of, 167
community mobilization, 205
Internet sales, 11-12, 20, 207-210
minimum age, 206
price and, 42
recommendations, 10-11, 20, 205, 210
youth restrictions, 118-119, 120, 159, 167, 203-206
Action on Smoking and Health, 110
Addictiveness of tobacco products. See Nicotine
adolescents, 89, 118-119
atypical patterns of smoking and, 93, 95
and cessation, 5, 117
conditioning, 79, 80
deception by tobacco industry, 7, 33, 35, 114, 121-122, 125, 127, 146, 148
environmental and personal factors, 80, 81, 201
flavorants and additives and, 283
genetic factors, 79, 82, 86-87, 96-97
industry acknowledgment of, 125
and litigation, 119, 121-122
nature of, 77-82
and paternalism issue, 151-152
as “pediatric disease,” 119, 148
physiological effects of smoke, 79
public understanding of, 7-8, 33, 35, 89, 108, 147
risk perception, 90, 91, 93
sensorimotor factors, 81
and tobacco control movement, 111-112, 116-118, 119
warning labels, 298
Adolescent tobacco use
alcohol policy compared, 153
cessation programs, 21
effectiveness of programs on, 11, 68, 124-125, 201
exposure to advertising, 320, 322-323
glamorization of smoking in movies and, 330-333
household bans on smoking and, 201-202
illegal sales, 164, 203
initiation rates, 3, 4, 5, 6, 11, 31, 34, 35, 45-46, 49, 51, 56-57, 70, 98, 112, 147-148, 149, 150-151, 167, 200
invulnerability concept and, 88, 89
media glamorization of smoking and, 330-333
mental illness and, 95
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motivation, 92-93, 98, 183
paternalism issue and, 34, 150-151
prevalence, 31, 46, 52-54, 124, 167-168, 169, 170-171
prevention interventions, 8, 11, 123
price of cigarettes as deterrent, 9, 183-184
restricted access to tobacco and, 118-119, 120, 159, 167, 203-206
risk perceptions and, 4, 5, 6, 8, 35, 88-93, 98, 149, 150-151, 187, 297
and smoking career, 58, 98
targeting by tobacco industry, 50, 112, 129, 148, 327-330
Adult tobacco use.
See also Young adult tobacco use
cessation rates, 4, 5, 49, 57, 66-67
ever smoked, 49
never smoked, 45
per capita consumption, 45, 54, 56, 168
prevalence, 1, 4, 5, 13, 29, 32, 45, 48, 51-52, 62, 64, 65, 66, 124, 125, 146, 166, 168, 170-171, 231, 278
risk perception and, 80, 90, 91, 151
Advertising. See Marketing and advertising
Advocacy.
See also Antitobacco activism;
Community mobilization
grassroots, 119, 147, 189, 196, 241-243, 244
African Americans, 60, 61, 62, 63, 64, 94, 161, 171, 185, 247
Age.
See also Adolescent;
Adult;
Young adult tobacco use
and initiation of smoking, 81, 94-95
minimum for tobacco purchases, 206
and nondaily smoking, 94
and prevalence of smoking, 52, 53, 58-59
Alabama, 174, 309, 311, 315
Alaska, 174, 309, 311, 315
Alcohol
excise taxes, 193
policy changes, 153, 241, 242, 273, 304-306
shipping restrictions, 210
American Academy of Family Physicians, 21, 222
American Academy of Pediatrics, 21, 222
American Cancer Society, 109, 110, 120, 179
American College Health Association, 20, 198, 199
American College of Emergency Physicians, 221
American College of Physicians, 21, 222
American Correctional Association, 19, 194-195, 196
American Heart Association, 109, 179
American Indian and Alaska Natives, 60, 62, 63, 64
American Jail Association, 194-195
American Legacy Foundation, 2, 123, 124, 129, 130, 133, 229-231, 243
American Lung Association, 109, 179
American Medical Association, 21, 109, 117, 120, 222
American Nonsmokers’ Rights Foundation, 198
American Nursing Association, 21, 222
American Psychiatric Association, 117
American Stop Smoking Intervention Study (ASSIST), 120, 121, 159, 163, 172, 241-242, 243, 244, 246
Annenberg Tobacco Survey, 89, 90
Antidepressants, 87
Antitobacco activism, early movements, 34, 107-108, 109-110, 115
Arizona, 115, 119, 160, 172, 174, 309, 311, 315
Arkansas, 66, 172, 309, 311, 315
Asians, 60-61, 62, 63, 64, 94, 161, 247
Attention-deficit/hyperactivity disorder, 96
Australia, 83, 201, 291, 292, 295
Austria, 213
B
Ballin, Scott, 117
Bangladesh, 292
Bans on smoking. See Restrictions on smoking
Banzhaf, John F., 110
Behavior Risk Factor Surveillance System (BRFSS), 46, 65, 93, 164, 165
Botvin, Gil, 212
Brain-derived neurotropic factor, 82
Brandt, Allan, 107
Brazil, 292, 293, 295, 297
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Bright Futures, 219
Brown and Williamson Company, 43, 209, 287
Bupropion treatment, 82, 87, 233
Bureau of Alcohol, Tobacco, Firearms, and Explosives, 209, 304
Bush Administration, 123
C
California
adolescent smoking, 167
Adult Tobacco Survey, 164
bans on smoking, 192, 195, 196, 202-203, 214, 245
cessation rates, 67, 136
Department of Education, 161
Department of Health Services, 161, 164
effectiveness of programs, 166-168, 169, 184, 192, 226, 242-243
evaluation of programs, 164, 165
excise taxes, 160, 161, 177, 184, 311
funding for tobacco control, 161-162, 166, 167, 175, 180, 315
Healthy Kids Program, 161
heart disease mortality, 166-167
marketing violations by industry, 320, 328
media campaigns, 120, 161, 184, 224-226, 227
MSA allocations, 178, 180, 320
nonsmokers’ rights movement, 147
per-capita cigarette consumption, 166, 167
prevalence of smoking, 66, 67, 94, 136, 165, 166, 167-168, 169, 170, 171
retail environment, 299-300
revenues and expenditures for tobacco control, 174, 177, 178, 180, 309
school-based interventions, 212, 214
Smokers’ Helpline, 161
Student Tobacco Survey, 168
Tobacco Control Program, 119, 120, 124-125, 157, 159, 160, 161-162, 163, 164, 165, 174
Tobacco Survey, 94, 164
youth access law, 208
Youth Tobacco Survey, 164
California Apartment Association, 196
Carlin, John, 305
Camel cigarettes, 43
Campaign for Tobacco-Free Kids, 179, 285
Canada
bans on smoking, 202
excise taxes, 183
health warnings on tobacco products, 291-292, 295
regretful smokers, 83
risk perceptions, 297
Cancer, 29, 30, 44, 89, 92, 108, 110, 115, 116, 125, 127, 191, 226, 247, 280, 297, 335, 337
Cardiovascular disease, 29, 30, 95, 110, 166-167, 191, 215-216, 247
Catechol-O-methyltransferase gene, 82
Center for Tobacco Prevention and Control, 163
Centers for Disease Control and Prevention, 21, 29, 128, 161, 192, 193, 224, 228, 238, 242, 244
Best Practices for Comprehensive Tobacco Control Programs, 159, 175, 176, 242, 335
BRFSS, 46, 65, 93, 164, 165
goals for tobacco control, 249
Guidelines for School Health Programs to Prevent Tobacco Use and Addiction, 109
IMPACT program, 120, 159, 246
Office on Smoking and Health, 22, 159, 172, 246
recommended funding level for state programs, 9, 19, 172-173, 175-176, 181-182, 308, 309-310
YRBSS, 46, 53, 171
Centers for Medicare and Medicaid Services, 126
Cessation attempt fatigue, 86
Cessation of smoking
abstinence defined, 85
access to programs, 12-13, 21-22, 84, 126, 129, 185
addictiveness of nicotine and, 5, 117
adolescent programs, 21
age trends, 58, 59
airway sensory replacement and, 81
behavioral and counseling interventions, 80, 87, 109, 126, 160, 161, 219, 220, 221, 222, 232, 233, 236, 240
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challenges, 84, 235-236
clinical practice guidelines, 87, 126, 129, 240
community mobilization, 222, 234, 236-237, 238
components of care management, 232
cost-effectiveness to interventions, 239-241
delivering services, 238-239
demand for programs, 234, 235-236
disseminating programs, 12, 13, 16, 17, 21, 22, 24, 87, 234, 235, 236-238, 303
duration of quit attempts, 85, 86
education about quitting process, 235-236
effectiveness of programs, 6, 12, 13, 68, 87, 159, 232-234, 236, 239-231
environment and, 16, 17, 24, 84, 86, 160, 192, 193, 201
ethical context for policies, 14, 34, 149-150
funding programs, 187, 240
gender differences, 62
genetic factors, 82, 97
geographic differences, 64, 65, 66-67
hardcore smokers, 6, 233, 234
health improvements, 231
industry discouragement of, 24, 323
initiation age and, 59
intensity of smoking and, 59, 85, 86-87, 97
intensity of treatment and, 232-233, 234
interventions, 6, 12, 21, 22, 120, 231-241
“light” cigarettes and, 297
limitations of programs, 234
mental illness and, 68, 69
motivation, 83, 109, 184, 221
nicotine replacement therapies, 17, 82, 87, 117, 147, 185, 233, 234
nondaily smoking and, 94
paternalism issue and, 149-150
pharmacotherapies, 82, 87, 109, 119, 126, 147, 233, 234, 240, 281-282
physician participation in, 83-84, 129, 219-222
and prevalence of smoking, 232, 235, 249, 250, 251-252
price of cigarettes and, 182-183, 184
quitlines, 21, 84, 126, 133, 161, 221, 236, 237
quitting attempts, 5-6, 65, 85-87, 97, 233, 234
surveillance and monitoring, 239
race/ethnicity and, 61
rates, 4, 5, 12, 45, 49, 57, 58, 62, 66-67, 82-83, 193
recommendations, 12, 21, 22, 236, 239
reimbursement for treatment, 12, 13, 22, 84, 126, 234, 238, 239-241
relapses, 86, 97, 193, 201, 233, 234
and smokeless tobacco use, 2, 3
socioeconomic status and, 63
Stages of Change model, 84-85
stepped-care approach, 232, 233, 234, 235, 239
trends, 31, 57, 77
warning labels on packages and, 295
Children, exposure to secondhand smoke, 115, 192, 199, 200-201
Chinese Americans, 61
Cigar smoking, 30, 41, 43, 198
Cigarette Labeling and Advertising Act, 110, 273, 300-301, 319
Cigarette manufacturing, 41-42, 107, 152
Cigarette Smoking Act of 1969, 110, 319
Cipollone, Rose, 113
Clinician’s Handbook of Preventive Services, 219
Clinton Administration, 119, 123
Clonidine, 87
Coalition for Tobacco-Free Colorado, 245
Coalition on Smoking OR Health, 109, 117
College, 20, 198, 199.
See also Young adult tobacco use
Colorado, 174, 243, 245, 309, 311, 315
Community Intervention Trial for Smoking Cessation (COMMIT), 83, 87, 192
Community mobilization
action projects, 213-214
alcohol policy compared, 241
cessation programs, 222, 234, 236-237, 238
education programs, 215-216, 230, 231
effectiveness, 215, 242, 244, 246
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evaluation of programs, 242, 246
expenditures, 175
funding, 159, 163, 244, 246
grassroots advocacy, 119, 147, 189, 196, 241-243, 244
lobbying challenge from tobacco industry, 121, 241, 243-244
local health departments, 161, 163
maintaining momentum, 244-246
recommendations, 246
school programs combined with, 214, 215-217, 218, 231
smoking bans, 115, 119, 189, 196, 203, 244-246
state strategy, 120-121, 154, 241-242
youth access restriction, 205
Comprehensive Smoking Education Act of 1984, 110
Comprehensive state programs.
See also Excise tax rates;
Restrictions on smoking;
individual states
CDC best practices, 159, 175, 176, 242
community mobilization strategy, 22, 120-121, 154, 241-242, 246
description, 160-163
effectiveness, 67, 68, 120, 124-125, 136, 157-158, 159, 160, 161, 165-172
elements of, 120, 152, 160
evaluation of, 120, 159-160, 164-165, 171-172
expenditures, 30, 158, 163, 173-176, 226, 309-310, 315-316
funding, 120, 128, 157, 158-159, 172-182, 226-227, 308-319
intensity of, 160
interventions, 158, 159
media campaigns, 119, 120, 159, 160, 161, 162-163, 224-229
monitoring and surveillance, 164
MSA allocations, 128, 178-181
public health partnerships, 154
recommendations, 181-182
revenue sources, 158, 176-181
youth access restrictions, 120, 159
Conduct disorders, 95
Congress.
See also Legislation
authority over states, 188 n.3
Cigarette Labeling and Advertising Act, 110, 273, 300-301, 319
Cigarette Smoking Act of 1969, 110, 319
Fair Housing Act, 197
Federal Smoking Prevention and Tobacco Control Act, 126, 206, 275
Food, Drug and Cosmetic Act, 117, 126, 152
proposed legislation, 275, 283-285, 307
Connecticut, 66, 67, 115, 125, 309, 311, 315
Consumer Product Safety Commission, 111
Consumer sovereignty issue, 7, 8, 32, 111, 114, 117, 145-146, 150-152.
See also Paternalism issue
Controlled Substances Act, 112, 152
Correctional facilities. See Inmates
Council for Tobacco Research, 111, 123
Council of Emergency Medicine Residency Directors, 221
Crawford, Victor, 226
Current Population Survey Tobacco Use Supplement, 46, 64, 96
Current smokers/smoking
cessation attempts, 82
correlates of, 57-68
decline in, 45
defined, 47, 166 n.2
intensity of smoking, 55
prevalence, 48, 51
CYP2A6 gene, 82
CYP2B6 gene, 97
D
Daily smoking/smokers, 52-53, 54, 55, 65, 95, 217
Davis, Ronald, 109
Deaths, 1-2, 29, 30, 34, 89, 113, 116, 126, 130, 166-167, 226, 228, 231
Decarboxylase, 82
Decisional Balance Inventory, 92
Decline in smoking
health scares and, 44, 109
Healthy People 2010 goals, 124
industry response to, 44, 46-51
maintaining momentum, 6-7, 30-31
media campaigns and, 124, 160, 184, 217, 218, 223, 225-226, 227, 228, 229, 230-231
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policy changes and, 130, 145
smoking bans and, 10, 94, 125, 184, 185, 191-202
trends, 4-5, 45-46, 70
Delaware, 125, 128, 173, 174, 175, 176, 179, 245, 308, 309, 311, 315
Denmark, 213
DHL, 209
Disabled individuals, 95
Discount brands, 133
Dopamine, 79, 80, 82, 97
Drug Abuse Resistance Education, 211
E
Eclipse cigarette, 127
Economic effects of tobacco use, 2, 30, 192, 195, 200, 239
Educational attainment
and nondaily smoking, 94
and prevalence of smoking, 6, 62-64, 65, 67, 96, 187
Educational initiatives, 109-110.
See also Media campaigns;
School-based interventions
community mobilization, 215-216, 230, 231
effectiveness, 70, 198
Emergency Medicine Residents Association, 221
Emergency Nurses Association, 221
Employee Retirement and Income Security Act, 273
Environmental tobacco smoke. See Secondhand smoke
Epidemiology of tobacco use.
See also Cessation of smoking;
Decline in smoking;
Initiation of smoking;
Intensity of smoking;
Prevalence of smoking
atypical patterns of smoking, 94
cessation rates, 82
decline in use, 4-5, 45-51
growth of problem, 4, 41-44
recent trends, 51-68
European Union, 292
Excise tax rates
and adolescent smoking, 183-184
appropriate level of, 159, 181, 182, 185-187, 249
avoidance, 9, 177, 184, 185-186, 188, 207
cessation services funded with, 187, 240
and cigarette use, 182-184
congressional authority over states, 188 n.3
disparities among states, 9, 176-177, 182, 186, 188-189, 308, 310-311
and expenditures for tobacco control, 178
external costs of consumption and, 186-187
federal, 10, 19, 50, 125, 185, 188, 189
funding tobacco control with, 9, 19, 159, 160, 162, 176, 177-178, 181, 182, 188-189, 218, 224, 227, 314-317
impacts of, 9, 170, 181, 182, 184, 185, 249, 250
interaction with other antismoking measures, 184-185
Internet retail shipments and, 185, 186, 207, 209, 210
new measures, 36, 188-189
recommendations, 9, 10, 17-18, 19, 25, 182, 189, 318
regressivity concerns, 187
revenues, 9, 174-175, 176, 177, 178
state, 9, 19, 119-120, 125, 158, 159, 160, 162, 170, 176-178, 182-189, 310-311
tax-exempt outlet sales and, 185, 207
F
Fair Housing Act, 197
Fairness Doctrine, 110, 113-114, 223-224
Family Smoking Prevention and Tobacco Control Act, 126, 206, 275
FDA Tobacco Rule, 126
Federal Acquisition Streamlining Act of 1994, 243
Federal Bureau of Prisons, 195
Federal Communications Commission, 110, 223
Federal Express, 209
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Federal Food, Drug, and Cosmetic Act, 117, 126, 152
Federal Trade Commission, 47, 110, 112, 113, 287, 299, 301
Fetal growth retardation, 110
Field Institute, 164
Filtered cigarettes, 44, 70, 323
Finland, 215
Firearms policy, 153
Florida
bans on smoking, 245
effectiveness of programs, 171-172, 229
excise tax rates, 311
funding for programs, 227, 315
media campaigns, 120, 224, 227-229
Medicaid litigation, 122-123
revenues and expenditures for tobacco control, 174, 224, 309
tobacco control program, 125, 128, 160, 174, 227-228
Youth Tobacco Survey, 228
Food and Drug Administration
authority, 17, 25, 36, 117, 118, 119, 122, 123, 126-127, 154, 203, 272, 275-277, 283-285, 307-308
integrity, 287-288
Tobacco Rule, 203, 205, 206, 276, 319, 323, 347
youth-oriented policy, 148, 276
Former smokers, 47, 57 n.7, 65
Framework Convention for Tobacco Control, 3, 34, 289, 292
Freedom of Information Act, 121, 243
Funding tobacco control.
See also Excise tax rates
allocation formula, 311-312, 314-318
American Legacy Foundation, 129
budgetary constraints, 9, 128, 157, 160, 161-162, 165, 166, 167, 171, 172, 180, 224, 226-227
and effectiveness of state programs, 160
federal role, 22, 159, 246, 308-319
MSA allocations, 9, 128, 129, 158, 163, 173, 174, 178-181, 227-228, 308-319
philanthropic, 22, 120, 246
prevalence-based penalties, 318-319
recommended and proposed spending, 9, 17-18, 19, 25, 172-173, 175-176, 181-182, 308, 309-310
remedial assessment on cigarettes, 312-313
state programs, 120, 128, 157, 158-159, 172-182, 224, 226-227, 308-319
G
Gallup Organization, 164, 167
Gamblers, 95
Gamma-aminobutyric acid 2 gene, 82
Gender differences.
See also Women, as marketing target
cessation of smoking, 62
initiation of smoking, 81
natural history of smoking, 58
motivation to smoke, 183
prevalence of smoking, 51, 58, 60-62
Generic brands, 50
Genetic vulnerability, 79, 82, 86-87, 96-97
Georgia, 174, 309, 311, 314, 315, 316, 317
Germany, 213
Glamorization of smoking, 6, 42, 110, 330-333
Gori, Gio, 287
Grassroots activism, 119, 147, 189, 196, 241-243, 244.
See also Antitobacco activism;
Community mobilization
Great Depression, 44
Group Against Smokers’ Pollution (GASP), 115
Growing Up Today Study, 183
Guide to Clinical Preventive Services, 219
Guidelines for Adolescent Preventive Services, 219
Guidelines for Health Supervision of Infants, Children, and Adolescents, 219
H
Hard-core smokers, 6, 8, 69, 96-97, 98
Harm reduction policies, 282
Hawaii, 174, 245, 309, 311, 315
Health Belief Model, 88
Health care expenditures, 2, 30
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Health Supervision Guidelines, 219
Healthy People 2010, 7, 13, 52, 124, 133, 135, 136, 199, 250, 251
Heavy smokers, 47, 54, 61, 68, 69, 95, 96, 145
Hispanics, 60, 61, 62, 63, 64, 94, 161, 247
History of tobacco use, 107-108
Home production of cigarettes, 185, 186
Homeless individuals, 6, 95, 96, 248
Hong Kong, 292
Hutchinson Project, 211
I
Idaho, 174, 245, 309, 311, 315
Illinois, 174, 309, 311, 315
Impotence, 294
Income
expenditures on cigarettes, 51
and prevalence of smoking, 6, 44, 62-64, 65, 67, 187
Inconsistent preferences, 151
India, 292
Indian reservations, 24, 185, 207
Indiana, 174, 213, 309, 311, 315
Industry. See Tobacco industry
Infant exposure to tobacco smoke, 29
Infectious diseases, 29
Initiation of smoking
adolescents, 3, 4, 5, 6, 11, 31, 34, 35, 45-46, 49, 51, 56-57, 70, 98, 112, 147-148, 149, 150-151, 167, 200
age and, 81, 94-95
defined, 56 n.6
deterrents, 7, 12-13
environment and, 200, 219
gender differences, 81
genetic influences, 81
psychiatric and behavioral comorbidities, 95-97
racial/ethnic differences, 69
regret among smokers, 5, 83, 88, 93, 97, 151
risk perceptions and, 6, 88-93
socioeconomic status and, 63
trends in rates, 13, 31, 45, 46, 49, 56-57, 77, 252
young adults, 5, 6, 45-46, 49, 57, 69, 70, 94-95, 167
Initiatives to Mobilize for the Prevention and Control of Tobacco (IMPACT) program, 120, 159, 246
Inmates, 6, 95, 96, 194-196
Institute of Medicine, 118, 119, 125, 130, 148
Insurance coverage, 12, 13, 22, 84, 126, 234, 238, 239-241
Intensity of smoking
age at initiation and, 98
and cessation, 59, 85, 86-87, 97
gender differences, 61-62
genetic factors, 81
per-capita consumption, 45, 54, 56, 166, 168-169
price of cigarettes and, 182, 183
and risk perception, 90
and smoking career, 59, 85, 98
socioeconomic status and, 69
trends, 5, 6, 45, 54-56
Interagency Committee on Smoking and Health, 126, 129
International Agency for Research on Cancer, 191
International Tobacco Control Policy Evaluation Survey, 294, 295, 297
International comparisons, 3, 34-35, 193, 291-293, 329
Interventions. See Cessation of smoking;
Prevention interventions
Iowa, 174, 213, 309, 311, 315
Ireland, 193
J
Jenkins Act, 207, 304
Joe Camel character, 50, 112
Joint Commission on Accreditation of Healthcare Facilities, 194
K
Kansas, 174, 179, 216, 305, 309, 311, 315
Kentucky, 65, 66, 94, 134, 135, 174, 176, 309, 311, 315
Kessler, David, 117, 118, 119, 122, 123, 148
Kessler, Gladys, 127-128, 287, 297-298, 318, 345
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Kluger, Richard, 107
Kool cigarettes, 43
Koop, C. Everett, 115, 122
Korean Americans, 61, 247
L
Legacy Media Tracking Surveys, 229
Legislation
advertising restrictions, 110, 118
bans on smoking, 36
exemptions for tobacco industry, 111-112
FDA empowerment, 126-127, 279-280, 283-285
proposed, 122, 276, 279-280, 283-285, 286-287, 295, 301
public health gains, 113
state excise taxes, 119, 210
warning labels, 110, 113, 126, 154, 273, 295
youth access control, 118, 210
Lethality of smoking, beliefs about, 89-90
Leukoplakia, 30
“Light” cigarettes, 89, 91-92, 112, 122, 123, 127, 280-281, 286, 287, 288, 296, 297-298, 303, 323, 325, 329
Light smokers (chippers), 95
Life Skills Training (LST), 211, 212-213
Litigation, 33
addictiveness of nicotine and, 119, 121-122
antilobbying challenge by industry, 121, 241, 243
class action suits, 121-122
common-law lawsuits, 196, 197
MSA, 50, 56, 122-123, 124, 125, 128, 129, 157, 178
Medicaid-related, 7, 122-123, 148, 157, 178
punitive damages, 128
regulatory challenges by industry, 119, 209
RICO, 123, 127-128, 157, 280-281, 287-288, 297-298, 318, 319, 345, 346
smokeless tobacco products, 127
tort claims, 113, 114, 121-122, 147, 197, 291
Lobbying
advocacy groups falsely accused of, 121, 241, 243-244
by tobacco industry, 111, 122, 157
Lorillard, 329
Louisiana, 174, 245, 309, 311, 315
Low-nicotine cigarettes, 48, 346-353
Low-tar cigarettes, 44, 48, 112, 117, 122, 280, 287, 296, 297, 298, 323
Low-yield products, 48, 280, 349
Lucky Strike cigarettes, 43
Luxembourg, 213
M
Maine, 124, 125, 128, 160, 173, 174, 208-209, 245, 308, 309, 311, 315
Malaysia, 292
Marketing and advertising
black-and-white text only, 302, 319, 323-327
constitutionality issues, 324-327
current practices, 48, 319-323
deceptive health claims, 43, 44, 117, 123, 125, 296-298
developing countries, 113
discount prices/coupons, 48, 50-51, 61, 302
effects of, 42, 43, 50-51, 61, 152, 321-323
expenditures by industry, 47-48, 114, 129, 299, 300, 302, 319-320
Fairness Doctrine, 110, 113-114, 223-224
in magazines, 300, 320, 321, 322, 323, 324, 331
point-of-sale, 16-17, 24, 114, 273-274, 299-301, 303, 319, 320-321, 322
promotional activities, 20, 50-51, 114, 118, 119, 123, 126, 129, 154, 184, 199, 289, 299-300, 301-303, 322
recommendations, 16-17, 18, 24, 25, 303, 324, 329
restrictions, 16-17, 18, 20, 24, 25, 48, 50, 110, 113-114, 119, 120, 123, 129, 154, 158, 159, 198, 199, 223-224, 273-275, 277, 287, 289, 300-301, 303, 324, 319-330
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sponsorships, 322
targeting women, 43, 50, 112
targeting youth, 20, 50, 112, 129, 148, 198, 199, 226, 287, 320, 323-324, 327-330
warnings on advertisements, 113
Marlboro Friday, 50
Marlboro Man, 226
Maryland, 174, 309, 311, 315
Massachusetts
Adult Tobacco Survey, 184
bans on smoking, 197, 245
community mobilization, 242
Department of Public Health, 162
effectiveness of programs, 165, 166, 168-171, 184, 227, 242-243
evaluation of programs, 164-165
excise taxes, 160, 162, 170, 177, 184, 311
funding for tobacco control, 162, 163, 172, 177, 315
media campaigns, 120, 133, 162, 184, 224, 226-227
per-capita cigarette smoking, 168-169, 170
prevalence of smoking, 165, 166, 168-171, 172
Prevalence Study, 171
revenues and expenditures for tobacco control, 163, 174, 224, 309
Smoker’s Quitline, 163
Tobacco Control Program, 119, 125, 128, 157, 160, 161, 162-163, 242-243
Tobacco Survey, 164
Try to Stop Resource Center, 163
Master Settlement Agreement (MSA), 9, 50, 56, 122-123, 124, 125, 128, 129, 157, 158, 163, 173, 174, 175, 176, 178-180, 181, 185, 206, 243, 287, 299, 313, 319-320, 322, 330
McCain, John, 122
McClarren, Wayne, 226
McHugh, John, 210
Media campaigns
American Legacy Foundation’s truth® Campaign, 124, 229-230, 332
effectiveness, 124, 160, 184, 217, 218, 223, 225-226, 227, 228, 229, 230-231, 249
elimination, 133, 223-224
evaluation, 225-226, 229, 231
expenditures, 226, 229, 230
exposure and receptivity, 227
Fairness Doctrine, 223-224, 229
funding, 11-12, 224, 225, 226-227, 238
goals, 225, 226
recommendations, 11-12, 20, 21, 218, 231, 238
school-based programs combined with, 11-12, 21, 215-218, 230-231
social marketing of cessation interventions, 237-238
state, 119, 120, 159, 160, 161, 162-163, 224-229, 241-242
youth-oriented, 11-12, 21, 57, 215-218, 224, 227, 228, 229
Medicaid, 12, 22, 30, 122-123, 148, 178, 240, 314
Medicare, 12, 22, 236, 240
Mental illness
and cessation therapy, 233, 234, 247
and prevalence of smoking, 6, 68, 69, 70, 95-96, 98
Menthol cigarettes, 43, 44, 48, 61
Michigan, 173, 174, 176, 179, 196-197, 308, 309, 311, 314, 315, 316, 317
Midwestern Prevention Project, 215, 216-217
Military personnel, 95, 107-108, 248
Minnesota, 93, 115, 122-123, 160, 174, 196, 309, 311, 314, 315, 316, 317-318
Class of 1989 project, 215-216
Smoking Prevention Program, 216
Mississippi, 122-123, 128, 160, 174, 308, 309, 311, 315
Missouri, 173, 174, 308, 309, 311, 315
Models. See Policy simulations
Monitoring the Future, 46, 52, 169
Montana, 174, 175, 245, 309, 311, 315
Moore, Michael, 122
Motion Picture Association of America, 25-26, 332-333
MSA. See Master Settlement Agreement
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N
National Academy of Sciences, 115
National Action Plan for Tobacco Cessation, 126
National Association of State Attorneys General, 209-210
National Cancer Institute, 21, 69, 238
ASSIST program, 120, 121, 159, 163, 172, 241-242, 243, 244, 246
Smoking and Tobacco Control Program, 109
Tobacco Working Group, 287
National Cancer Policy Board, 125
National Committee for Quality Assurance, 239
National Health Interview Survey, 46, 48, 49, 52, 53, 55, 59, 60, 62, 63, 82, 85, 94, 95, 199
National Household Survey on Drug Abuse, 63
National Institutes of Health, 34, 128, 182-184, 201-202, 204, 211, 230, 235, 240
National Quitline Network, 21, 126, 221, 237, 318
National Research Council, 115, 125
National Survey on Drug Use and Health, 45, 46, 56, 58, 61, 63
National Survey on Environmental Management of Asthma and Children’s Exposure to Environmental Tobacco Smoke, 199
National Youth Tobacco Survey, 199
Natural history of smoking, 58-59
Nebraska, 174, 309, 311, 315
Nevada, 174, 179-180, 309, 311, 315
New Hampshire, 173, 174, 308, 309, 311, 315
New Jersey, 174, 176, 189, 245, 309, 311, 315
New Mexico, 174, 309, 311, 315
New York, 122, 125, 172, 174, 185, 181, 182, 193, 207, 209, 210, 213, 245, 309, 311, 315
New Zealand, 292
Nicotine
addiction/addictiveness, 5, 77-82, 95, 97, 111-112, 116-118, 119, 121-122, 125, 146, 147, 148, 151-152
drug classification, 152
FDA regulation, 117-118, 119, 125
filtered cigarettes, 44
flue curing and, 42-43
illegal drugs compared, 58, 153
industry manipulation of levels, 118, 152
“light” cigarettes, 92, 112
low-level exposures, 95
maintenance approach to policies, 278
medicinal alternatives, 281-282, 283
menthol cigarettes, 61
neuroadaptation, 80
priming effect on children of smokers, 201
product differences, 43
and quitting, 4, 5, 97
reduction strategy, 154, 281, 282-283, 346-353
replacement products, 17, 82, 87, 117, 147, 185, 233, 234
and smoking career, 59, 97
tolerance to, 82
withdrawal, 80
Nicotinic acetylcholine receptor alpha4 gene, 82
NNK, 280
Nondaily smoking, 93-95, 166
North Carolina, 174, 176, 180, 309, 311, 315
North Dakota, 174, 175, 245, 309, 311, 315
North Karelia project, 215
Nortriptyline, 87
O
Ohio, 66, 174, 200, 309, 311, 315
Oklahoma, 66, 174, 309, 311, 315
Oregon, 160, 172, 174, 177, 185, 201, 242, 309, 311, 315
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P
Packaging of tobacco products.
See also Warning labels
corrective communications, 24, 298-299
misleading messages, 24, 289, 296-298
other health information, 296
promotional, 289
recommendations, 16, 23, 24, 298
regulation of, 24, 289, 296-298
Parental smoking, 29, 110, 186-187, 200-201, 218, 219
Paternalism issue, 7, 111, 149-152, 202.
See also Consumer sovereignty issue
Pennsylvania, 174, 176, 213, 305, 309, 311, 315
Philip Morris, Inc., 50, 112, 121, 122, 125, 126-127, 313, 326, 328, 345
Physicians
antismoking, 111
prosmoking, 108
screening, educating, and counseling smokers, 83-84, 129, 219-222
Poland, 291
Policy analysis and development.
See also Policy simulations
incentives for manufacturers, 345-346
innovations worthy of study, 344-346
nicotine content reduction, 154, 346-353
recommendations, 26, 342
wholesale purchasing monopsony, 344-346
Policy framework.
See also Regulation of tobacco;
Restrictions on smoking;
Tobacco control measures
alcohol policy compared, 152
blueprint outline, 3, 35-36, 154
charge to committee, 31-35
consumer sovereignty issue, 7, 8, 146-147, 150-152
context for, 7-8, 146-148
ethical context, 33-34, 148-150
federal role, 154, 272-275
firearm policy compared, 152
goals, 32, 278-279
horizon for projections, 32
inherent dangers of tobacco and, 8, 152-153
paternalism problem, 7, 33-34, 111, 146, 147, 149-152
product safety problem, 8, 145-146
slippery slope argument, 153
state role, 154
youth-oriented, 8, 147-148, 153
Policy simulations
black and gray market behavior, 343
health outcomes tracking, 343-344
industry response element, 343
intensities of smoking in, 343
models, 342-344
reduced-nicotine cigarette, 154, 351-352
SimSmoke model, 130-133, 134, 249-251
state-dependent or endogenous transition rates, 342
steady-state scenario, 4, 6-7, 131-133, 136, 249, 250
strengthened policies (best-case), 4, 12-13, 137, 249-253
System Dynamics Model, 130-133, 134, 135, 136, 251-252
uncertainty in, 130-131, 133
worst-case scenario, 4, 6-7, 133-137, 250
Potential reduced-exposure products (PREPs), 15, 23, 282, 284-285, 286, 288, 289, 302-303, 344-346
Pregnancy, smoking during, 29, 110, 187, 200, 234
Prevalence of smoking.
See also Decline in smoking
adolescents, 31, 46, 52-54, 124, 167-168, 169, 170-171
adults, 1, 4, 5, 13, 29, 32, 45, 48, 51-52, 62, 64, 65, 66, 124, 125, 146, 166, 168, 170-171, 231
age and, 52, 53, 58-59, 278
bans on smoking and, 192-193, 198, 201
cessation rates and, 232, 234, 251-252
defined, 97
nondaily patterns, 93-94
educational attainment and, 62-64, 65, 67, 96, 187
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gender and, 51, 52, 53, 61-62
geographic differences, 64-68, 134, 273
income and, 62-64, 65, 67, 187, 248
initiation rates and, 251-253
goals, 251
Master Settlement Agreement and, 56
media campaigns and, 160
mental illness and, 6, 68, 69, 70, 247
and motivation to quit, 85
penalties based on, 318-319
price of cigarettes and, 56, 170, 182-184
projections, 12-13, 231, 249-253, 271;
see also Policy simulations
race/ethnicity and, 60-61, 62, 64, 247
trends, 6-7, 52-54
surveillance and monitoring, 333-335
young adults, 198
Prevention interventions.
See also Media campaigns;
School-based interventions
for adolescents, 8, 11, 123
applicable tobacco products, 32
cost-effectiveness, 149
delivery of services, 221-222
expenditures on, 2
health care-based, 20-21, 210, 219-222
implementation, 32, 214
parent- or family-based, 11, 210, 218-219, 222
recommendations, 20-21, 222
synergistic effects, 184-185
for vulnerable populations, 247-248
Price of cigarettes, 5, 7, 9, 10, 16, 24, 42, 44 n.1, 48, 50, 56, 94, 120, 125, 129, 132, 133, 136, 170, 182-185, 186, 187, 191, 226, 236, 300, 301, 302, 303, 304, 305, 311, 314, 320, 321, 323, 324.
See also Excise tax rates
Project SHOUT, 211, 213-215
Project STAR, 216
Promotions. See Marketing and advertising
Public Health Cigarette Smoking Act, 110
Public health remedies
educational initiatives, 109-110
secondhand smoke campaign, 114-116
tobacco industry response, 110-114
Puerto Ricans, 61
Puerto Rico, 66, 94, 185
Pure Food and Drug Act of 1906, 149, 274
Put Prevention into Practice, 219
Q
Quitlines, 21, 84, 126, 133, 161, 221, 236, 237
Quitting. See Cessation of smoking
R
Rabin, Robert, 122
Race/ethnicity
and cessation of smoking, 61
and initiation age, 69
and intensity of smoking, 69
and mortality related to smoking, 61, 247
and nondaily smoking, 94
and prevalence of smoking, 60-61, 62, 63, 64, 247
Racketeer Influenced and Corrupt Organizations Act (RICO), 123, 127-128, 280-281
Reduced-nicotine cigarette strategy
feasibility, 347-351
impact, 351-352
nicotine content warnings, 352
recommendations, 26, 352-353
taxation based on nicotine content, 352-353
Regret, 5, 83, 88, 93, 97, 148, 149, 150, 151, 153, 187
Regulation of tobacco
alcohol experience compared, 304-306
cigarette testing methods, 15, 23, 281, 284, 287, 288, 296
content disclosure, 23, 283-284, 288
enforcement practices, 10, 203-205, 207
exemptions for tobacco industry, 111-112
FDA empowerment, 14-15, 22, 119, 275-277, 288-289
federal authority, 36, 111, 158, 272-275, 283-285, 307-308
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federal-state relationship, 158, 272-275
goals of, 277-279, 281-283
harm reduction from continued use, 278, 281-282, 286
Internet sales and delivery, 207-210
“legitimization” concerns, 277, 285
nicotine content, 15, 119, 281-283, 284
packaging characteristics, 276, 289-299
potential reduced-exposure products, 15, 23, 282, 284-285, 286, 288, 289, 302-303
product characteristics, 15, 23, 111, 279-289
product standards, 15, 23, 276, 284, 288-289
proposed legislation, 275, 283-285
public health concerns, 277, 285-286
recommendations, 14-18, 22-26, 275, 288-289
retail environment, 10-11, 20, 203-210, 273, 277, 283, 299-308
risks and benefits, 286-289
state authority, 272, 273
warning labels, 110, 113, 126, 154, 273, 276, 290-296
Respiratory diseases and disorders, 29, 30, 108, 110, 181-182, 200, 220-221, 222
Restrictions on smoking.
See also Secondhand smoke
on airlines, 115, 116, 121-122
in child care facilities, 116, 190
and cigarette consumption by
smokers, 192-193, 201
on college campuses, 198-199
in correctional facilities, 190, 194-196
constitutionality, 195
coverage of state laws, 189, 190
effects of, 10, 94, 125, 184, 185, 191-202
grassroots activism, 115, 119, 152, 189, 196, 244-246
in hospitals and health care facilities, 19, 190, 194
and initiation of smoking, 201-202
industry response to, 121
legislation, 36
in multiunit residential locations, 196-197
and nonsmoker health, 191-192
in outdoor spaces, 202-203
in privately owned vehicles, 20, 199-202, 222
in public buildings, 147, 184, 189-191, 193-194
on public transportation, 115, 116, 121-122, 189, 190
recommendations, 10, 19, 20, 194, 196, 197, 199, 202, 203
in residences, 20, 199-202, 219, 220, 222
in restaurants and bars, 115, 125, 190, 191, 193-194, 245
statewide, 125
in workplaces, 115, 147, 184, 189-194, 201, 245
Retail environment
adult purchases for minors, 206
age verification, 207-209, 327, 328
alcohol experience compared, 304-306
buydowns, 301-302
on college campuses, 198
federal role, 307-308
on Indian reservations, 24, 304
Internet sales, 11-12, 20, 133, 185, 186, 207-210
licensing mechanisms, 10, 20, 204, 206, 304-305, 306-307
models for regulation, 304-307
monitoring compliance, 10, 203-205, 206
monopoly systems, 304-306
promotional activities, 289, 299-303, 322;
see also Marketing and advertising
promotional allowances, 50-51, 301-303
point-of-sale advertising, 114, 299-301
recommendations, 10-12, 16-17, 20, 24, 205, 210, 303, 307
restructuring options, 306-307
self-service displays and vending machines, 10, 205, 206
slotting fees, 301, 302-303
Rhode Island, 125, 174, 175, 176, 208, 245, 309, 311, 315
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Risk perceptions
addiction and cessation, 90, 91, 93
adolescents, 4, 5, 6, 8, 35, 88-93, 98, 149, 150-151, 187, 297
adults, 80, 90, 91, 151
effects of smoking, 89-91
level and stage of smoking and, 90, 95
“light” cigarettes, 91-92, 296-297
media campaigns and, 160
optimism bias, 89, 150, 151-152
and paternalism issue, 150-151
smokeless tobacco, 2, 31
warning labels on cigarettes and, 293
R.J. Reynolds Company, 43, 48, 50, 112, 118, 127, 313, 320, 326
Robert Wood Johnson Foundation, 120, 159, 161, 164, 243, 244
S
Sackman, Janet, 226
Safe and Drug-Free School Act, 11, 20, 218
School-based interventions.
See also individual programs
CDC guidelines, 109
community mobilization component, 214, 215-217, 218, 231
effectiveness, 211-217, 249-250
evaluation of, 212, 213, 216
funding, 11, 218
media campaign combined with, 215-218, 230-231
recommendation, 11, 20, 21, 218-219
school-only programs, 211-215
social competence approach, 212-213
social influences approach, 211-212, 216, 217
Schroeder, Steven, 120
Secondhand smoke, 34.
See also Restrictions on smoking
campaign against, 35, 114-116, 147, 159, 163, 226
children exposed to, 115, 192, 199, 200-201
common-law lawsuits, 196, 197
deaths, 1-2, 29, 88, 116
economic costs, 30, 192, 195, 200
effects of smoking bans, 125, 191-202
and external costs of cigarettes, 186-187
harm reduction products, 127
health hazards, 115, 147, 191, 192, 200
monitoring exposure, 165, 229
and paternalism issue, 147, 149, 150, 152
tort litigation, 121-122, 147
warning labels, 298
Self-Regulation Theory, 88
Serotonin, 79, 82, 97
Singapore, 292
Smokeless cigarette, 117, 325
SmokeLess States program, 120, 159, 161, 243-244, 246
Smokeless tobacco, 2-3, 30, 31, 41, 127, 281
Smokers, defined, 47
Smuggling and black markets, 3, 14, 34, 177, 185, 186, 188, 189, 195, 278, 279, 289, 350-351
Social costs of smoking, 30, 33-34, 146, 148-149, 152, 186-187
Social norms
antismoking, 5, 7-8, 115, 246
prosmoking, 6, 98, 129
Socioeconomic status
See also Educational attainment;
Income
and access to interventions, 247-248
Some-day smokers, 65 n.11, 93-94
South Africa, 292
South Carolina, 173, 174, 176, 188 n.3, 308, 309, 311, 315, 317
South Dakota, 174, 175, 245, 309, 311, 316
Spain, 213
Stanford University, 164, 167
States.
See also Comprehensive state programs;
individual states
early smoking bans, 152
excise tax revenues by, 177
MSA allocations by, 179
nondaily smoking rates, 94
prevalence of smoking by, 64-68
tobacco control revenues and expenditures by, 174-175
variation in policies among, 9, 176-177, 182, 186, 188-189, 273
Sudden infant death syndrome, 29, 192, 200
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Surgeon General’s reports, 4, 35, 45, 70, 77, 78, 79, 88, 108, 109, 110, 111, 113, 115, 117, 118, 119, 122, 147, 148, 151, 158, 242
Survey of Health-Related Behaviors Among Active Duty Military Personnel, 248
Synar Amendment, 118, 203-204
T
Taiwan, 292
Tar, 92.
See also Low-tar cigarettes
Teen Tobacco Summit, 228
Tennessee, 66, 173, 174, 308, 309, 310, 311, 316
Terry, Luther, 113
Texas, 122-123, 160, 174, 193, 310, 311, 316
Thailand, 291, 292, 295
Theory of Planned Behavior, 88
Thompson, Tommy, 126
Tobacco and Alcohol Prevention Project (TAPP), 211-212
Tobacco control measures.
See also Community mobilization;
Comprehensive state programs;
Excise tax rates;
Funding tobacco control;
Policy simulations;
Regulation of tobacco
campaign against secondhand smoke, 114-116
effectiveness, 5, 6, 7, 68, 94, 124-128
evaluation of, 6, 333-335
expenditures, 30, 128
future of, 4, 128-136
inherent danger of tobacco products and, 152-153
international, 3
legislation, 110, 111-112
litigation strategies, 113-114, 121-123
modern movement, 108, 109-116
nicotine as addictive drug and, 116-118
political momentum, 2, 124-128, 157
retail shipments, 207-210
smuggling as threat to, 3
special populations, 247-248
state actions, 119-121;
see also Comprehensive state programs
status of, 138-129
status-quo policies, 4, 6-7, 131-133
strengthened policies, 4, 8-12, 249-253
surveillance and monitoring, 26, 120, 333-335
weakened policies, 4, 6-7, 133-136
youth access restrictions, 118-119, 203-206
youth exposure restrictions, 330-333
Tobacco industry.
See also Litigation;
Marketing and advertising
cigarette mass production, 41-42, 107, 152, 327-330
deceptive practices, 7, 33, 35, 114, 121-122, 125, 127, 146, 148, 225, 226, 228, 274-275, 280-281, 285-286, 298, 345-346
discouraging cessation, 24
economic assistance to growers, 126, 180
mandatory payments for tobacco control, 308-319
motivating conduct changes, 345-346
new product development, 46, 48, 112, 127, 145
nicotine manipulation, 117
political and commercial power, 157
pricing strategies, 46, 48, 50-51
profits, 313
public relations and lobbying campaigns, 110-114, 121, 123
response to decline in product use, 44, 46-51
response to public policy advocacy, 121, 241, 243-244
transnational companies, 34, 113
youth education and prevention programs, 327-330
Tobacco Institute, 111, 115, 123
Tobacco Related Disease Research Program, 161
Toxic Substances Control Act, 111, 152
Transtheoretical Model of Change, 88
U
U.S. Department of Defense, 248
U.S. Department of Education, 11, 20, 218
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U.S. Department of Health and Human Services, 21, 203-204, 238, 333
Clinical Practice Guideline for Treating Tobacco Use and Dependence, 87
Healthy People 2010, 7, 13, 52, 124, 133, 135, 136, 199, 250, 251
National Quitline Network, 126, 237
U.S. Department of Justice, 280, 318, 346
U.S. Environmental Protection Agency, 116, 147, 199
U.S. Government Accountability Office, 180
U.S. Postal Service, 209-210
U.S. Public Health Service, 240
U.S. Securities and Exchange Commission, 313
United Kingdom, 83, 295, 297
University of California, 161
San Diego, 164
University of Massachusetts Medical School, 163
University of Southern California, 164, 167
UPS, 209
Utah, 67, 94, 125, 174, 177, 245, 310, 311, 316
V
Varenicline, 87, 233
Venezuela, 292
Vermont, 67, 125, 127, 175, 245, 310, 311, 316
Mass Media Project, 215, 217
Veterans Health Administration, 248
Vietnamese Americans, 61, 247
Virgin Islands, 66
Virginia, 175, 180, 310, 311, 316
Virginia Slims, 50, 112
Vulnerable populations, 6, 22, 57, 69, 95-97, 98, 247-248, 334
W
Warnings labels.
See also Packaging of tobacco products
on advertisements, 113, 154, 290
black-and-white text, 291, 295
Canadian experience, 16, 23, 291-292, 295, 296
on carton wrappers, 292
current policy, 290-291
effectiveness, 294-296
graphic/pictorial, 15-16, 23, 291-293, 294, 295, 296
health risks, 110, 113, 126, 154, 276, 290-293
industry endorsement of, 126
international comparisons, 291-293
legislation, 110, 113, 273
recommendations, 15-16, 23, 296
size and placement, 292-293
and tort claims, 291
smuggling, 289
Washington, D.C., 94, 115, 128, 159 n.1, 170, 173, 174, 175, 178, 179, 190, 191, 207, 224, 245, 308, 309, 311, 315, 318, 319
Washington state, 125, 175, 196, 207, 245, 310, 311, 316
We Card program, 327, 328
West Virginia, 65, 94, 175, 310, 311, 316
Winston cigarettes, 48
Wisconsin, 175, 310, 311, 316
Women, as marketing target, 43, 50, 112
Women’s liberation movement, 112
World Health Organization, 3, 34, 113, 117, 289, 292, 347
World War I, 43
World War II, 44, 152
Wyoming, 175, 304, 310, 311, 316
Y
Young adult tobacco use
on college campuses, 198-199
initiation of smoking, 5, 6, 45-46, 49, 57, 69, 70, 94-95, 98, 167
prevalence, 46, 58, 70, 167
prevention interventions, 11
price of cigarettes as deterrent, 50, 183, 184
targeting by industry, 50
Youth.
See also Adolescent tobacco use correctional facilities, 195
Youth Behavior Risk Surveillance System (YRBSS), 46, 53, 171
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