The Surgeon General's report Reducing Tobacco
Use (1) was released on August 9, 2000. This report is the first in the series to offer a composite review of the
various methods used to reduce and prevent tobacco use.
The six major conclusions of the report are:
Efforts to prevent the onset or continuance of tobacco use face the
pervasive, countervailing influence of tobacco promotion by the tobacco industry, a
promotion that takes place despite overwhelming evidence of adverse health effects
from tobacco use.
The available approaches to reducing tobacco use---educational, clinical,
regulatory, economic, and comprehensive---differ substantially in their techniques and in
the metric by which success can be measured. A hierarchy of effectiveness is difficult
Approaches with the largest span of impact (economic, regulatory,
and comprehensive) are likely to have the greatest long-term population impact.
Those with a smaller span of impact (educational and clinical) are of greater importance
in helping persons resist or abandon the use of tobacco.
Each of the modalities reviewed provides evidence of effectiveness.
Educational strategies, conducted in conjunction with community- and
media-based activities, can postpone or prevent smoking onset in 20% to 40% of
Pharmacologic treatment of nicotine addiction, combined with behavioral
support, will enable 20% to 25% of users to remain abstinent at 1 year
posttreatment. Even less intense measures, such as physicians advising their
patients to quit smoking, can produce cessation proportions of 5% to 10%.
Regulation of advertising and promotion, particularly that directed at
young persons, is very likely to reduce both prevalence and uptake of smoking.
Clean air regulations and restriction of minors' access to tobacco products
contribute to a changing social norm with regard to smoking and may influence
An optimal level of excise taxation on tobacco products will reduce the
prevalence of smoking, the consumption of tobacco, and the long-term health
consequences of tobacco use.
The impact of these various efforts, as measured with a variety of techniques, is
likely to be underestimated because of the synergistic effect of these modalities.
The potential for combined effects underscores the need for comprehensive approaches.
State tobacco control programs, funded by excise taxes on tobacco products
and settlements with the tobacco industry, have produced early, encouraging evidence
of the efficacy of the comprehensive approach to reducing tobacco use.
Additional information about the report or a free copy of the executive summary
is available from CDC's Office on Smoking and Health, National Center for Chronic
Disease Prevention and Health Promotion, CDC, Mailstop K-50, 4770 Buford Highway, NE,
Atlanta, Georgia 30341-3724; telephone (770) 488-5705. Copies of the full report (stock
no. 017-001-00544-4) can be purchased for $43 from the Superintendent of Documents,
U.S. Government Printing Office, Washington, DC 20402-9328; fax (202) 512-1650. The
executive summary of the report will be published as an
MMWR Recommendations and Reports. Copies of the full report, the executive summary, and At A Glance also may
be downloaded from CDC's World-Wide Web site, http://www.cdc.gov/tobacco.
US Department of Health and Human Services. Reducing tobacco use: a report of
the Surgeon General. Atlanta, Georgia: US Department of Health and Human Services,
CDC, National Center for Chronic Disease Prevention and Health Promotion, Office on
Smoking and Health, 2000.
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