The burden of smoking-attributable disease and premature
death and its high costs to the nation will continue
for decades unless smoking prevalence is reduced
more rapidly than the current trajectory. The evidence in
this report shows that the nation may fail to achieve the
Healthy People 2020 objective of reducing the prevalence
of smoking among adults to 12%. Model estimates suggest
that if the status quo in tobacco control in 2008 were
maintained, the projected prevalence of smoking among
adults in 2050 could still be as high as 15% (Chapter 15).
Trends in smoking rates among youth and adults show
progress, but the prevalence of current smoking among
youth and adults is only slowly declining and the actual
number of youth and young adults starting to smoke has
increased since 2002 (Figure 3). Additionally, the use of
multiple tobacco products is increasingly common, especially
among young smokers. Concerns remain that use of
these new products may increase initiation rates among
youth and young adults, delay quitting, and prolong the
smoking epidemic.
The tobacco industry continues to position itself to
sustain its sales by recruiting youth and young adults and
by maintaining current smokers as consumers of all their
nicotine-containing products including cigarettes (see
Chapters 13, 14, and 15). As reviewed in Chapter 14, U.S.
District Judge Gladys Kessler entered her final opinion
and order on August 17, 2006, and found that the tobacco
industry defendants violated the Racketeer Influenced
and Corrupt Organizations (RICO) Act by lying, misrepresenting,
and deceiving the public “including smokers
and the young people they avidly sought as ‘replacement
smokers,’ about the devastating health effects of smoking
and environmental tobacco smoke” (U.S. v. Philip Morris
2006:852). The Tobacco Control Act incorporates as
congressional findings of fact Judge Kessler’s determinations
that “the major United States cigarette companies
continue to target and market to youth,” that the companies
sought to “encourage youth to start smoking subsequent
to the signing of the Master Settlement Agreement