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September 18, 1996

The Ledger of Tobacco Control-Reply

Author Affiliations

Henry Ford Health System Detroit, Mich

JAMA. 1996;276(11):873. doi:10.1001/jama.1996.03540110027023

To the Reply.  —In my Editorial, I focused on "assets" and "liabilities" in tobacco control that are national in scope. Coverage of important accomplishments in individual states and communities—such as the 3 state tobacco tax initiatives mentioned by Dr Glantz (and the 1 in Michigan, which he failed to mention)—was not possible in the space available. Nevertheless, these initiatives do represent the most aggressive actions against tobacco use in the United States to date and serve as model policies for adoption by other states and, ideally, by the nation as a whole.Mr O'Malley points out that many smokers receive pleasure from smoking. Of course they do, but 70% of smokers want to give up this pleasure, according to national surveys,1 yet have not succeeded in quitting because of the addictive nature of smoking. O'Malley also argues that most smokers are aware that smoking is unhealthy. This is true, but large numbers