Although cigarette smoking by adults has declined steadily since the 1960s, smoking by adolescents has risen sharply since 1992. In 1999, the Centers for Disease Control (CDC, 2000a) reported that teenage daily smoking increased 73 percent between 1988 and 1996. Coincidentally (or not), 1988 was the first full year, and 1996 the last, that R. J. Reynolds featured the "Joe Camel" cartoon-advertisement campaign (which had considerable appeal among children). The increase in adolescent smoking in the 1990s has been attributed to a variety of factors, including the targeting of youths by tobacco companies, teen emulation of media celebrities, and the ineffective health-based antismoking efforts of the 1980s and 1990s.

In light of the upsurge in teen smoking in the 1990s and the highly addictive nature of tobacco, smoking prevention is considered to be particularly important. The 1994 U.S. Surgeon General's report, "Preventing Tobacco Use Among Young People," estimated that...