Reaching toward and beyond the year 2000 goals for cigarette smoking. Research and public health priorities

The 1980s witnessed decreases in adult smoking prevalence in the face of increasing morbidity and mortality from past and current tobacco use. To facilitate even greater cessation activity, innovative research continues to be conducted on methods of improving intensive, individual approaches to smoking cessation, particularly through pharmacologic intervention. However, the major thrust in this country today is toward broad, systemic, public health campaigns, targeting selected high risk groups and the general public. Vulnerable populations continue to include various ethnic groups, especially those with unusually low or high prevalence, women, persons with smoking‐related diseases, and heavy smokers. Self‐help methods, physician advice, work site and community based interventions, and antismoking coalitions have been in the forefront. Methodologic and intervention studies are needed, concurrent with ongoing large scale public health efforts. What efforts in research and in the public arena are requisite to reach the year 2000 goals for tobacco use? Prevention remains the number one priority. Bringing about a substantial decline in teenage smoking will require the combination of school based programs, environmental and advertising restrictions, and societal revision of norms toward the relative dangers of smoking and drug use in adolescence. Research is needed to define the optimal combinations of such interventions with booster components to sustain effects. Public health efforts, symbolized by the Community Intervention Trial for Smoking Cessation (COMMIT) and the American Stop Smoking Intervention Study (ASSIST) programs, must be combined with stronger advocacy, taxation, antismoking policy formation and implementation to realize a smoke free society.