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34 CHAPTER 2 ■ Reducing Tobacco Use in the United States

1988–2005: Progress once nicotine was declared an addictive agent
• A 1988 Surgeon General’s report concluding that nicotine is an addictive agent,
undermining the tobacco industry’s position that smoking is a “free choice.”
• Recognition that most smokers become addicted in their teens.
• U.S. Food and Drug Administration (FDA) control of cigarettes beginning in 1996,
with new regulations limiting youth access and advertising targeting young people.
• States taking the lead in creating smoke-free spaces and new anti-tobacco
coalitions in states beginning to affect important policy actions.
• The people of California passing Proposition 99, a referendum that increased
the excise tax on tobacco from 10 to 35 cents per pack and earmarked 20
percent of the new revenues for a statewide anti-smoking campaign.
• State litigation, including the Master Settlement Agreement with the major
tobacco companies that required companies to pay an estimated $206 billion to
46 states between 2000 and 2025 and to support a new charitable foundation—
which became the American Legacy Foundation. (IOM, 2007, pp. 107–127)

Further Reductions in Tobacco Use: “A Blueprint for the Nation”
In 2007, the Committee on Reducing Tobacco Use presented 43 recommendations
to achieve three distinct goals related to reducing tobacco use, published in Ending
the Tobacco Problem: A Blueprint for the Nation (IOM, 2007, p. 3):

1. Reduce tobacco product use initiation.
2. Increase cessation.
3. Reduce exposure to environmental tobacco smoke.

This chapter focuses on two success stories—one related to the first goal of pre-
venting initiation (the truth® Campaign) and the other to the second goal of in-
creasing cessation (Washington State’s Quit Line). More information on these 43
recommendations appears at the end of this chapter.

CASE STUDY 1
®
The truth Campaign
Youth Tobacco Prevention: Empowering Teens With truth ®

B A CKG ROU N D, P U RP OSE, A N D F OCUS

truth®, launched in February 2000, is the largest national youth smoking
prevention campaign in the United States and the only national prevention
campaign not directed by the tobacco industry (see Figure 2-1).