"Science tends to generalize, and generaliza tions mean simplifications . . . . And generaliza tions are also more satisfying to the mind than details. Of course, details and generalizations must be in proper balance: Generalizations can be reached only from details, while it is the generalization which gives value and interest to the detail:' . . . (A. Szent-Gyorgy, Science 1964) The first edition of this book, published in German as Tabak abhiingigkeit in 2001, was prompted by the fact that no single volume was available in Germany or elsewhere summarising the adverse repercussions of cigarette smoking on human health. As far as my own research was able to ascertain, the last comprehensive work dealing with this subject was writ ten in Germany by the Dresden internist, F. Lickint, whose Tabak und Organismus was published in 1939 by the Hip pokrates-Verlag. All subsequent monographs in this field have tended to focus on detailed aspects, and there has been no shortage of publications on subjects such as how smokers can quit smoking, healthy eating for smokers etc. Friends and colleagues abroad have urged me to prepare an English language version of Tabakabhiingigkeit. In gladly complying with this suggestion, I have intentionally prepared an up dated and slightly enlarged new edition, taking account of the rapidly proliferating literature on the subject up to the start of 2002. The harmful sequelae of smoking are played down by politicians in many industrialised countries, including Ger many.

This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.

Tobacco use by adolescents and young adults poses serious concerns. Nearly all adults who have ever smoked daily first tried a cigarette before 26 years of age. Current cigarette use among adults is highest among persons aged 21 to 25 years. The parts of the brain most responsible for cognitive and psychosocial maturity continue to develop and change through young adulthood, and adolescent brains are uniquely vulnerable to the effects of nicotine. At the request of the U.S. Food and Drug Administration, Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products considers the likely public health impact of raising the minimum age for purchasing tobacco products. The report reviews the existing literature on tobacco use patterns, developmental biology and psychology, health effects of tobacco use, and the current landscape regarding youth access laws, including minimum age laws and their enforcement. Based on this literature, the report makes conclusions about the likely effect of raising the minimum age to 19, 21, and 25 years on tobacco use initiation. The report also quantifies the accompanying public health outcomes based on findings from two tobacco use simulation models. According to the report, raising the minimum age of legal access to tobacco products, particularly to ages 21 and 25, will lead to substantial reductions in tobacco use, improve the health of Americans across the lifespan, and save lives. Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products will be a valuable reference for federal policy makers and state and local health departments and legislators.

This Surgeon General's report details the causes and the consequences of tobacco use among youth and young adults by focusing on the social, environmental, advertising, and marketing influences that encourage youth and young adults to initiate and sustain tobacco use. This is the first time tobacco data on young adults as a discrete population have been explored in detail. The report also highlights successful strategies to prevent young people from using tobacco

The nation has made tremendous progress in reducing tobacco use during the past 40 years. Despite extensive knowledge about successful interventions, however, approximately one-quarter of American adults still smoke. Tobacco-related illnesses and death place a huge burden on our society. Ending the Tobacco Problem generates a blueprint for the nation in the struggle to reduce tobacco use. The report reviews effective prevention and treatment interventions and considers a set of new tobacco control policies for adoption by federal and state governments. Carefully constructed with two distinct parts, the book first provides background information on the history and nature of tobacco use, developing the context for the policy blueprint proposed in the second half of the report. The report documents the extraordinary growth of tobacco use during the first half of the 20th century as well as its subsequent reversal in the mid-1960s (in the wake of findings from the Surgeon General). It also reviews the addictive properties of nicotine, delving into the factors that make it so difficult for people to quit and examines recent trends in tobacco use. In addition, an overview of the development of governmental and nongovernmental tobacco control efforts is provided. After reviewing the ethical grounding of tobacco control, the second half of the book sets forth to present a blueprint for ending the tobacco problem. The book offers broad-reaching recommendations targeting federal, state, local, nonprofit and for-profit entities. This book also identifies the benefits to society when fully implementing effective tobacco control interventions and policies.

Simon Chapman is one of the world’s leading advocates for tobacco control, having won the coveted Luther Terry and WHO medals. His experience straddles 30 years of activism, highly original research and analysis, having run advocacy training on every continent and editing the British Medical Journal’s Tobacco Control research journal. In this often witty and personal book, he lays out a program for making smoking history. He eviscerates ineffective approaches, condemns overly enthusiastic policies which ignore important ethical principles, and provides a cookbook of strategy and tactics for denormalising smoking and the industry which promotes it. Public Health Advocacy and Tobacco Control is divided into two sections. The first contains chapters spanning such key topics as the place of advocacy in tobacco control, ethical issues, smoking cessation and prevention, harm reduction and product regulation and the denormalisation of smoking. The second section provides an invaluable A-Z of tobacco control advocacy strategy from Accuracy to Whistleblowers.

Tobacco is ranked as one of the major public health disasters of modern times. This book pulls together the science of tobacco-related diseases with the policy of tobacco control to offer a comprehensive preventive medicine/public health approach.