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Adults versus teenagers: a false dilemma and a dangerous choice
  1. National Center for Tobacco-Free Kids
  2. 1707 L Street, NW, Suite 800
  3. Washington, DC 20036, USA;

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    The world has a compelling interest in reducing the morbidity and mortality caused by tobacco use. The question is not whether society should try to prevent the death toll from tobacco use, but rather how this objective can best be achieved. The answer is not simple given the complex relationship between the state of scientific knowledge (what we know about what is and is not effective in reducing tobacco use) and the capacity and will of government and society to adopt and implement the most effective strategies.

    There is no dispute that, in the long run, public health efforts must seek to reduce tobacco use by young people and adults. However, there is an intense debate about what to do in the short run—focus exclusively on reducing adult tobacco use or focus on preventing children from starting. There are those who argue that programmes should not seek to reduce the number of children who use tobacco. They argue that these programmes are doomed to failure, do not work, and divert needed resources from those that do. They also argue that youth-oriented programmes are actually harmful because they inevitably bolster the tobacco industry's goal of creating the impression that, although it is wrong for children to use tobacco, there is no reason to discourage adults from doing so.

    The premise of this article is that it is a mistake to allow the public health policy choice to be framed as whether to focus on adults or on children. The very debate assumes that a choice must or can acceptably be made, and that real progress can be attained by focusing on one, but not the other. Both assumptions are false. The push to frame the policy as an either/or choice—whether made by the tobacco industry, politicians or tobacco control advocates—should be …

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