by Richard J. Bonnie and Barbara S. Lynch

About the authors: Richard J. Bonnie and Barbara S. Lynch were members of the Institute of Medicine’s Committee on Preventing Nicotine Addiction in Children and Youths and coedited the committee’s report, Growing Up Tobacco Free: Preventing Nicotine Addiction in Children and Youths.

In the 1990s, it has become disturbingly clear that the remarkable progress made in recent decades in reducing tobacco use has stalled, if not stopped. In 1964, when the surgeon general first raised warnings about the health hazards of cigarettes, 40.4 percent of adults smoked. By 1990, only about 26 percent did. Unfortunately, there it has leveled off. In addition, the use of smokeless tobacco, especially snuff and chewing tobacco, has become a serious problem. But the biggest reason progress in reducing tobacco use is in...