We have a very strong panel today, the members of which will speak about different projects, broader than smoking cessation, which are going on in the real world in managed care environments. The panel will give us some ideas about how public health and managed care organisations can work together to achieve this national goal of doing something about tobacco use. We are at that junction now where we have the greatest hope of something happening. We are faced with the prospect of national legislation—some may say the spectre of national legislation—not knowing whether it is going to be good or bad, or what will come as a result of it. In any eventuality, I believe the future will provide additional resources for prevention programmes, smoking cessation efforts, and for surveillance and research.

For these resources to work together in an effective manner, the public health community and the managed care community need to share a vision about what is to be accomplished. That vision will have to be divided equally between clinical cessation service delivery and a focus on population health, public health, and policy change. Rather than having tension between the two, I think we should strive to achieve synergy from a comprehensive approach, through which cessation clinical activities are reinforced by policies that restrict smoking. The organisations represented at this meeting are active in the community in terms of getting healthy public policies around tobacco. Together, we can overcome obstacles that have thwarted us for our lifetimes. That is what is so exciting about today.

When I go out and speak, I have the opportunity to comment on how we are living in a paradoxical time. We have the greatest cause of death in the United States “on the ropes” but, at the same time, we treat it like candy. You can open up any magazine and see advertisements where tobacco is made to appear glamorous, sophisticated, and alluring—so things have not changed yet. We have never had such potential for change as we approach the next century—but the prices of tobacco products are still lower in the United States than any developed country in the world. This meeting captures that potential well, where people from around the country, coming together for a common cause, can make change happen.

Our panel is composed of people who really are “doing” tobacco control and public health in managed care right now. The first speaker is Jenny DesVaux Oakes, director of public and community relations (at Sierra Health Services) from Southern Nevada. She will discuss the collaboration between managed care and public health organisations to address the targeting of smoking in young people in Nevada. Jenny will be followed by Trish Seghers, health promotion administrator for Group Health Northwest in Spokane, Washington. Trish will tell us what a small grant invested in counter-advertising was able to accomplish regarding smoking in teenagers. And lastly, Sandra Sandell, advisor for the Tobacco Initiatives Health Partners in Minnesota will tell us how the partners in her state took on access by young people with a smart, no-nonsense media campaign and other types of tobacco control and media efforts. We have an accomplished panel who can offer excellent examples of how managed care organisations are working on different aspects of tobacco control.