On behalf of my colleagues at the Robert Wood Johnson foundation, let me say that we are very pleased to help support this conference—the first in a series of conferences to recognise and stimulate innovation in the prevention and treatment of tobacco addiction in managed care. It is gratifying to see so many people here who share the vision of an expanded role for managed care in tobacco control.

I should like to examine, from the perspective of the Robert Wood Johnson Foundation tobacco portfolio, where managed care interventions fit in the larger national tobacco control agenda, and why we at the foundation see them as integral to improving health and health care for all Americans. I shall also briefly describe some of the foundation programmes that have laid the groundwork for our new initiative, Addressing Tobacco in Managed Care.

Our most recent annual report focuses specifically on the opportunities and challenges that a market-driven healthcare system present for funding in each of our three major goal areas—assuring access to basic health care; improving care for chronic disease; and reducing the harm caused by substance use. The report notes that the explosive growth in managed care, with its interest in keeping people healthy to contain cost and its ability to institutionalise change, brings new opportunities, especially for grant-making in the field of substance abuse.

Although it is our newest goal, reducing the harm caused by substance abuse has reached parity, accounting last year for fully a third of the foundation’s grants. The sum of our active and committed funds in tobacco control totals a little over $120 million. Tobacco control has been a priority for the foundation because tobacco use and addiction remain the United States’ number one cause of preventable death and disease. Tobacco not only causes more than …