Strategies to reduce youth tobacco use: opportunities for local government.

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Published by This issue of the American Journal of Preventive Medicine examines factors associated with youth tobacco use–a timely topic given that this year is the 50th anniversary of the first Surgeon General’s Report on Tobacco. In 1960, the outlook was grim. The probability that a boy born in 1960 would be smoking by the time he was 20 years old was about 35%. After more than a dozen Surgeon General’s Reports describing the health consequences of tobacco use, the youth smoking rate in 1991 was still 27.5%. To reduce youth and adult tobacco use, states and localities have employed a number of interventions–smoke-free air laws now cover almost half of the U.S. population, and 30 states have cigarette taxes of $1.00 per pack or higher. As a result of these efforts, the youth smoking rate over the last two decades has declined by one third to 18.1% in 2011– much higher than it should be, but a figure that represents considerable progress. Although youth cigarette use has decreased over time, the growing use of other tobacco products threatens to undermine these gains. The research in this issue examines youth use of various products, including hookah, cigars, smokeless tobacco, and e-cigarettes, specifically looking at factors influencing use such as advertising, coupons, warning labels, and perception and curiosity of tobacco products. With the emergence and growing popularity of other tobacco products, localities have seized a number of regulatory opportunities to curb youth tobacco, including limiting access to cigars, limiting exposure to coupons, and increasing the minimum sales age. Cigar use among youth has increased nationally, even surpassing cigarette smoking in some states, because many regulations that apply to cigarettes do not apply to cigars. This loophole has led to the increasing popularity of cigars and little cigars, which are nearly identical to cigarettes except that they are wrapped in brown tobacco