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April 24, 1996

The Ledger of Tobacco Control: Is the Cup Half Empty or Half Full?

Author Affiliations

From the Center for Health Promotion and Disease Prevention, Henry Ford Health System, Detroit, Mich.

JAMA. 1996;275(16):1281-1284. doi:10.1001/jama.1996.03530400069040

A dozen years ago, then—Surgeon General C. Everett Koop called for a smoke-free society by the year 2000. That goal became a rallying cry for legions of health professionals and health advocates who anguished over the harm wreaked by the most important preventable cause of death in our society.

Only 4 years remain in this millennium, and society as a whole will not be smoke free in the year 2000. In fact, smoking prevalence among adults in the United States leveled off from 1990 to 1993—at about 25%—after 25 years of consistent decline.1,2 Moreover, smoking prevalence increased in 1995 for the fourth consecutive year among eighth- and tenthgraders, and for the third consecutive year among high school seniors.3

On the other hand, much of society is already smoke free— many workplaces, homes, and public transport lines, for example. Public hostility toward the promotion and use of tobacco continues