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Recommendation 8: Colleges and universities should ban smoking in indoor locations, including dormitories, and should consider setting a smoke-free campus as a goal. Further, colleges and universities should ban the promotion of tobacco products on campus and at all campus-sponsored events. Such policies should be monitored and evaluated by oversight committees, such as those associated with the American College Health Association.

Recommendation 9: State health agencies, health care professionals, and other interested organizations should undertake strong efforts to encourage parents to make their homes and vehicles smoke free.

Recommendation 10: States should not preempt local governments from restricting smoking in outdoor public spaces, such as parks and beaches.

Recommendation 11: All states should license retail sales outlets that sell tobacco products. Licensees should be required to (1) verify the date of birth, by means of photographic identification, of any purchaser appearing to be 25 years of age or younger; (2) place cigarettes exclusively behind the counter and sell cigarettes only in a direct face-to-face exchange; and (3) ban the use of self-service displays and vending machines. Repeat violations of laws restricting youth access should be subject to license suspension or revocation. States should not preempt local governments from licensing retail outlets that sell tobacco products.

Recommendation 12: All states should ban the sale and shipment of tobacco products directly to consumers through mail order or the Internet or other electronic systems. Shipments of tobacco products should be permitted only to licensed wholesale or retail outlets.

Recommendation 13: School boards should require all middle schools and high schools to adopt evidence-based smoking prevention programs and implement them with fidelity. They should coordinate these in-school programs with public activities or mass media programming, or both. Such prevention programs should be conducted annually. State funding for these programs should be supplemented with funding from the U.S. Department of Education under the Safe and Drug-Free School Act or by an independent body administering funds collected from the tobacco industry through excise taxes, court orders, or litigation agreements.

Recommendation 14: All physicians, dentists, and other health care providers should screen and educate youth about tobacco use during

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