Tobacco control policies and their impacts. Past, present, and future

The 1964 Surgeon General's report on smoking and health concluded that "Cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action." The adoption of remedial actions over the next half century produced what is arguably the most important public health triumph of that period in the United States and in other developed nations. At the heart of the remedial actions were governmental policies. By raising cigarette price, taxation is especially effective at reducing smoking, encouraging some smokers to quit and others to reduce their daily consumption, while also discouraging the initiation of smoking by children. Smoke-free workplace policies have dramatically reduced workers' exposure to the toxins in cigarette smoke, smoking, employers' costs, and the incidence of acute myocardial infarctions. Other policies have also helped diminish the toll of smoking. The successes of tobacco control notwithstanding, future progress will occur slowly unless society finds new, possibly radical "endgame" strategies to hasten the arrival of a smoke-free society.