1. What are the effective population- and community-based interventions to prevent tobacco use in adolescents and young adults, including among diverse populations?
2. What are the effective strategies for increasing consumer demand for and use of proven individually oriented cessation treatments, including among diverse populations?
3. What are the effective strategies for increasing the implementation of proven population-level tobacco-use cessation strategies, particularly by healthcare systems and communities?
4. What is the effect of smokeless-tobacco-product marketing and use on population harm from tobacco use?
5. What is the effectiveness of prevention and of cessation intervention in populations with co-occurring morbidities and risk behaviors?
6. What research is needed to make the most progress and greatest public health gains nationally and internationally?

Tobacco use remains the nation’s leading preventable cause of premature death. Each year, more than 440,000 Americans die from disease caused by tobacco use, accounting for one in every five deaths. Cigarette smoking alone is responsible for more than 30% of cancer deaths annually in the United States, and smoking is also an important cause of death from heart disease, stroke, and chronic obstructive pulmonary disease. Currently, there are an estimated 44.5 million (21%) adult smokers and an estimated 3.75 million (22%) high school student smokers in the United States. Cigarettes are the predominant form of tobacco consumed; however, other forms of tobacco, such as smokeless tobacco, cigars, and pipes, are also used. In addition to the toll on human lives, tobacco use places an enormous economic burden on society. For 1995 to 1999, estimated annual smoking-attributable economic costs in the United States were $75.5 billion for direct medical care for adults and $81.9 billion for lost productivity.

Despite enormous progress in reducing the prevalence of tobacco use in this country, it is unlikely that the Healthy People 2010 objectives of reducing smoking prevalence to 12% or less in adults and 16% or less in youth will be reached on schedule. A better understanding of how effective strategies for prevention and treatment can be developed and implemented across diverse segments of the population is crucial to accelerate progress; meeting the Healthy People 2010 prevalence goals would prevent a projected additional 7.1 million premature deaths after 2010. This conference has been planned to facilitate an objective review of the available evidence to clarify what is known and what research gaps remain concerning the conference questions.