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C H APT E R

Reducing Tobacco

Use in the

United States

A Public Health Success

Story . . . So Far

Nancy R. Lee

Knowing is not enough; we must apply.
Willing is not enough; we must do.
—Goethe

In 1964, almost half (42%) of the adults in the United States smoked cigarettes. By
2007, that number had declined to 20% (CDC, 2007; IOM, 2007). And among
youth, the prevalence of daily smoking among 12th-graders decreased from 23%
in 1999 to 12% in 2006 (IOM, 2007). These near 50% declines have been charac-
terized as one of the 10 greatest achievements for the United States in public
health in the 20th century (IOM, 2007). The stories, strategies, and unfinished
business for this public health hazard are covered in this chapter, with a focus on
inspirational youth smoking prevention and adult cessation efforts.

U N ITE D STATE S: A C O U N TR Y OVE RVI EW

The United States of America is situated mostly in central North America and is
comprised of 50 states plus Washington, DC, the capital district. The United States