I shall begin with an overview of the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health and the evolution of its important relationship with the managed care world over the past few years.

Dr Jeffrey Koplan, previously head of the National Center for Chronic Disease Prevention and Health Promotion, in which the Office on Smoking and Health is housed, became the new director of the CDC in October 1998. Two of his priorities for the agency are strengthening the science base for public health action and collaborating with health care partners for prevention. A primary reason for my presence at this meeting was to reinforce this acknowledgment that we cannot accomplish our public health objectives without working closely with our health care partners; managed care organisations (MCOs) are critical in this regard. And one of the first collaborations between the CDC and MCOs was on reducing tobacco use.

During a meeting between CDC and its public health partners held in Atlanta in 1995, participants examined the issue of how MCOs and health maintenance organisations (HMOs) could become more involved with programs to reduce tobacco use.1 Rather than highlighting cessation at this meeting, we tried to take a broader public health view towards tobacco control by identifying various policy interventions in which MCOs can involve themselves, including prevention, minors' access, school programs, and treatment activities. We also discussed the role MCOs could play related to clean indoor air policies, not only within managed care health facilities (which hopefully were all smoke free in 1995 and certainly are now) but also in terms of helping communities pass laws that would protect non-smokers from the adverse effects of second hand smoke (also called environmental tobacco smoke (ETS)).

Additionally, we discussed the effects of tobacco industry advertising and of …