NEW YORK, Dec 21 (Reuters Health) -- The nationwide goal to have only 15% of the population smoke by the year 2000 will not be met, according to researchers reporting in the November/December issue of the American Journal of Health Promotion.

Dr. C. Tracy Orleans from the Robert Wood Johnson Foundation, Princeton, New Jersey, and Dr. K. Michael Cummings of the Roswell Park Cancer Institute, New York, point out that about 25% of adults living in the United States still smoke. While dramatically fewer than in 1964, when 40% of adult Americans smoked, the ``decline (in smoking) among adults has stalled, and youth rates have risen, with over 8,000 children and teens becoming new smokers each day,'' they state. The leveling off of those who smoke and those who quit is occurring despite the success of various treatment strategies that currently help 25 to 30% of motivated smokers to quit for good. This quit rate can almost be doubled by using medications including buproprion, an anti-anxiety drug, and nicotine replacement therapy along with other strategies, they add. The authors acknowledge that more work ``needs to be done to reach smokers in low-income and minority populations'' as well as special groups of people such as highly addicted smokers. Although people who succeed in quitting often can do so without the help of any formal treatment program, ``most people who try to quit on their own fail.'' they note. The authors therefore suggest a number of ways to make treatment programs more accessible to more smokers. One way would be to cover treatment costs by using taxes raised from tobacco sales. Prevention programs in the schools and in the community could be improved upon, as could smoking cessation programs offered through the workplace. The authors also note that 70% of people who smoke visit their doctor each year. This gives doctors an opportunity to reach all but 30% of the 50 million people who now smoke in the U.S. ``Smokers receiving even 2 to 3 minutes of physician advice to stop smoking... are twice as likely to quit as smokers (who do not receive advice),'' the authors note. Other measures to help people stop smoking include higher taxes, restrictions on smoking in public places and advertising warning people against smoking. ``The nation has reached a point of unprecedented potential to reduce the social, economic and health harms caused by tobacco,'' the authors write. Policies now need to be put in place to improve smokers' access to prevention and treatment programs, especially for those who are most likely to smoke, they suggest. SOURCE: The Journal of Health Promotion 1999;14:83-86.

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