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Innovative approaches to youth tobacco control: introduction and overview
  1. K E Warner1,
  2. P D Jacobson1,
  3. N J Kaufman2
  1. 1Department of Health Management & Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
  2. 2President, Strategic Vision Group, Princeton Junction, New Jersey, USA
  1. Correspondence to:
 Kenneth E Warner, PhD, Department of Health Management & Policy, School of Public Health, University of Michigan, 109 S Observatory Road, Ann Arbor, MI 48109-2029, USA; 
 kwarner{at}umich.edu

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Cigarette smoking is a vicious cycle. Each year a new generation of children experiments with smoking. In many societies, half of them will become addicted, most destined to smoke for decades thereafter until either they manage to quit or death ends their struggle to do so. The glamorous, seductive, and youthful images of cigarette advertising copy—the ruggedly handsome cowboy pulling on his cigarette, the sexy and impossibly lean female toying with hers—give way over time to the harsh reality of wizened faces and tar coated lungs that gasp urgently for breath. Smoking kills one of every two life long smokers. The unlucky half loses an average of 15 years of life compared with people who never smoke. Their children or grandchildren become their replacement smokers. The cycle repeats itself again and again, year after year.

The fraction of young people who begin to smoke is not constant year to year, however. In the USA, 38.8% of high school seniors had smoked within a month of being surveyed in 1976. That figure fell gradually to a low of 27.8% in 1992 and then rose, rapidly, to 36.5% five years later in 1997. A mere five years thereafter—in 2002—the percentage of monthly smokers had fallen to 26.7%, the lowest figure ever recorded in the 27 year history of the survey. Among their younger schoolmates, the proportionate changes during the 1990s were even more dramatic: 20.8% of 10th graders were monthly smokers in 1991, a figure that jumped to 30.4% in 1996 and then plunged to 17.7% in 2002. Among eighth graders, the comparable figures were 14.3% in 1991, 21.0% in 1996, and 10.7% in 2002.1

What is it that caused the proportion of high school seniors smoking to rise by almost a third from 1992 to 1997 and then to drop …

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