Saul Shiffman

I am going to ask Dr Husten to start by responding to the comment that we are stuck in our progress toward the Year 2000 goals.

Corinne G Husten

We are not stuck, but certainly we are not, as Dr Orleans said, proceeding at a fast enough pace to meet the Healthy People 2000 objectives. National prevalence is now 25 % - 27.7% among males and 22.5% among females. There are several groups that still have a very high prevalence. Education is the major correlate with smoking: people with 16+ years of education have a prevalence rate of 14 %; for high school graduates, it is 29 %; for persons with nine to 11 years of education, it is 37 %. That is a very high risk group. We also have high risk groups on racial and ethnic lines; American Indians and Alaskan natives especially have very high smoking rates.

Highest risk groups for men are primarily those with low education, American Indians and Alaskan natives, and African Americans; and for women, American Indians and the Alaskan natives. So we certainly have populations that have a very high prevalence, and overall it does not look like we are going to meet the Healthy People 2000 goals.

Saul Shiffman

Why are we stuck, and who are we failing to reach? I am hearing about several important populations, defined by ethnicity, by education, and maybe defined by amount of smoking. How are we failing to reach those groups ?

Joyce Essien

It seems to me, having just come from a planning meeting to design a violence prevention intervention, that this ought to be achievable in comparison to what I have just spent the past week thinking about.

I wonder how different out strategies would be if the Year 2000 goal had been to eradicatesmoking, and how different would …