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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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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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Ending the Tobacco Problem: A Blueprint for the Nation 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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Ending the Tobacco Problem: A Blueprint for the Nation 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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Ending the Tobacco Problem: A Blueprint for the Nation 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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Ending the Tobacco Problem: A Blueprint for the Nation 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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Ending the Tobacco Problem: A Blueprint for the Nation 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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Ending the Tobacco Problem: A Blueprint for the Nation 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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Ending the Tobacco Problem: A Blueprint for the Nation 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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Ending the Tobacco Problem: A Blueprint for the Nation 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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Ending the Tobacco Problem: A Blueprint for the Nation 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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Ending the Tobacco Problem: A Blueprint for the Nation 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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Ending the Tobacco Problem: A Blueprint for the Nation 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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Ending the Tobacco Problem: A Blueprint for the Nation 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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Ending the Tobacco Problem: A Blueprint for the Nation 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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Ending the Tobacco Problem: A Blueprint for the Nation 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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Ending the Tobacco Problem: A Blueprint for the Nation 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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Ending the Tobacco Problem: A Blueprint for the Nation 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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