Smoking is the leading preventable cause of death and is responsible for more than 480,000 deaths per year in the United States.[1]  

Right now, more than 16 million Americans are living with a disease caused by smoking, while every day more than 3,200 children age 18 or younger smoke a cigarette for the first time.[2]  Preventing cigarette use among youth is critical to reducing addiction rates. Nearly 90% of smokers had their first smoke by age 18 and 98% of adult smokers first smoked by age 26.[3] CADCA believes focusing efforts on lowering initiation rates for this age demographic can have a dramatic impact on decreasing the amount of future, long-term users of tobacco products and stem the use of other drugs.

There is also evidence to suggest that smoking cessation (discontinuing tobacco smoking) is linked to reduced prevalence of Substance Use Disorders (SUD’s). A study conducted by Dr. Patricia Cavazos-Rehg found that smokers who had quit use reported fewer continuing or recurrent SUD’s by 69 percent compared to those who continued smoking at or near their initial intensity[4].

Moving forward, tobacco policy needs to maintain a robust focus on preventing youth use of tobacco products. U.S. policy has come a long way in the past several decades, but there is still much more that can be done. Below is a brief history of some key developments.

1906 – The First federal food and drug law is passed (Food and Drugs Act of 1906) – did not include tobacco.

1938 – The Federal Food, Drug and Cosmetic Act is passed adding a definition for a drug as "articles (other than food) intended to affect the structure or any function of the body of man or other animals".

1938 – The Federal Trade Commission Act is amended allowing the FTC to "prevent persons, partnerships, or corporations... from using unfair or deceptive acts or practices in commerce".

1965 – The Federal Cigarette Labeling and Advertising Act is passed requiring companies to issue package warning labels stating "Caution: Cigarette Smoking May Be Hazardous to Your Health".

1970 – Comprehensive legislation called the Controlled Substances Act (CSA) is passed to prevent the abuse of narcotics, drugs and other addictive substances – tobacco is excluded as a “controlled substance”.

1998 – Philip Morris USA, R.J. Reynolds, Brown & Williamson and Lorillard, along with forty-six states and six other major U.S. jurisdictions enters into the Master Settlement Agreement (MSA).

-The MSA-

  • Forbids participating cigarette manufacturers from directly or indirectly targeting youth
  • Imposes restrictions on the sale and marketing of cigarettes and restricts or bans cartoons, transit advertising, billboards, outdoor advertising, branded merchandise, among other things, by participating cigarette manufacturers
  • Requires participating cigarette manufacturers to provide compensation for taxpayer money spent on health-care costs associated with tobacco use

2005 – The World Health Organization (WHO) Framework Convention on Tobacco Control is put into effect with 168 signatories to coordinate international efforts on demand and supply reduction strategies

2006 - U.S. District Judge Gladys Kessler rules that several major tobacco, including Phillip Morris, Altria Group Inc., and Reynolds American Inc., had knowingly and fraudulently covered up the health risks associated with smoking and actively marketed their products to children. The companies were required to publicize admissions that they deceived the American public on the dangers of smoking.

2009 – The Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act) is passed giving the Food and Drug Administration (FDA) for the first time, the ability to regulate cigarettes, cigarette tobacco, roll-your-own tobacco, and smokeless tobacco.

2012 – The Centers for Disease Control and Prevention (CDC) launches the first-ever paid national tobacco education campaign:  Tips from Former Smokers (TIPS) in March 2012, which profiles individuals who are living with serious long-term health effects from smoking and secondhand smoke exposure. As of September 2013, TIPS is reported to have motivated 1.6 million smokers to attempt quitting, with 100,000 who have stopped altogether.[5]

2016 – FDA issues final regulations broadening their authority to all tobacco products, which includes new regulatory authority over e-cigarettes, cigars and a variety of other tobacco products. The rule also prohibits the sale of “covered tobacco products” to individuals under the age of 18 and requires the display of health warnings on cigarette tobacco, roll-your own tobacco, and covered tobacco product packages and in advertisements.

The FDA’s rule is a momentous step forward for the field of tobacco prevention. To this day, the tobacco landscape continues to change dramatically. The proliferation of flavored tobacco and the emergence of e-cigarettes present new, unique challenges for lawmakers and public health officials, especially those concerned with youth addiction. In 2014, for the first time, more teens reported using e-cigarettes over any other tobacco product on the market[6] with e-cigarette use tripling from 4.5 percent in 2013 to 13.4 percent in 2014 for high school students and from 1.1 percent in 2013 to 3.9 percent in 2014 for middle school students[7].

Some e-cigarette manufacturers have recognized the increased use by youth and developed marketing campaigns that are attractive to them, such as promotion of a wide variety of candy-flavored liquids. Advertising efforts have also focused on e-cigarettes as a healthier alternative to traditional cigarettes, despite the real risk of promoting nicotine addiction, and the adverse effect this poses for youth use.

In fact, the dangers of e-cigarette use is already beginning to be documented. In 2014, the CDC released a Morbidity and Mortality Weekly Report (MMWR) that found e-cigarettes accounted for an increasing proportion of combined monthly e-cigarette and cigarette exposure calls, increasing from 0.3% in September 2010 to 41.7% in February 2014. E-cigarette exposure calls were also more likely to report adverse health effects than cigarette exposure calls and callers commonly reported vomiting, nausea and eye irritation[8]. CADCA is very concerned that the trend toward higher use of e-cigarettes and the subsequent negative effects could continue unless more resources are focused on prevention efforts.

CADCA commends FDA’s decision to assert its regulatory authority over e-cigarettes and is encouraged by efforts such as the FDA’s “The Real Cost” campaign, launched in February, 2014, across multiple media platforms, which aims to educate at-risk youth about the harmful effects of tobacco use. The campaign puts particular focus on preventing youth who demonstrate an openness to smoking from trying cigarettes and preventing the transition from youth experimentation to youth regular use of smoking products[9].

CADCA is actively involved in education, advocacy and legislative efforts to improve prevention efforts aimed at reducing tobacco use among youth. To learn more about current tobacco specific legislation and policy click here.


[3] US Department of Health and Human Services. The Health Consequences of Smoking ---

50 Years of Progress: A Report of the Surgeon General. 2014. Accessed at on December 8, 2014.

CADCA Tobacco Legislative Position Letters


(FDA) E-Cigarette Tobacco Rider Letter


(EO) Deeming Rule Letter to White House


(CDC-OSH) Senate FY17 Appropriations Letter


(CDC-OSH) House FY17  Appropriations Letter


Tobacco Control Measure TPP