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Current Status of Tobacco Policy and Control

Paoletti, Luca MD*; Jardin, Bianca PhD; Carpenter, Matthew J. PhD; Cummings, K. Michael PhD, MPH; Silvestri, Gerard A. MD, MS*

doi: 10.1097/RTI.0b013e3182518673

Behaviors pertaining to tobacco use have changed significantly over the past century. Compared with 1964, smoking prevalence rates have halved from 40% to 20%, and as a result there has been a slow but steady decline in the rates of tobacco-induced diseases such as heart disease and cancer. Growing awareness of the health risks of smoking was aided by the US Surgeon Reports that were issued on a nearly annual basis starting from 1964. Concerns about the hazards of breathing in second-hand smoke further contributed to the declining social acceptance of smoking, which evolved into regulatory actions restricting smoking on buses, planes, retail outlets, restaurants, and bars. Today, 23 states and 493 localities have comprehensive laws restricting indoor smoking. This paper examines public policies that have made a significant impact on smoking and lung cancer rates and discusses potential future research directions to further reduce the diseases caused by smoking.

*Department of Medicine, Division of Pulmonary and Critical Care Medicine

Departments of Psychiatry

Psychiatry and Behavioral Sciences, Hollings Cancer Center, Cancer Prevention and Control, Medical University of South Carolina, Charleston, SC

Dr Silvestri has received funding in the form of a K24 grant from the National Institute of Health (NIH) and has received grant funding from Olympus. Dr Carpenter has received funding in the form of an NIH Career Development Grant (NIDA K23 grant). Dr Cummings has received grant funding from the NIH, has received payment from the NIH as a grant reviewer, has received payment from Pfizer for consulting work, and has been a paid witness for plaintiffs in litigation against the tobacco industry. For the remaining authors none were declared.

The authors declare no conflicts of interest.

Reprints: Gerard A. Silvestri, MD, MS, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, 96 Jonathan Lucas St., CSB 812 Suite 812 Charleston, SC 29425 (e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.