ABSTRACT
The first documented reports of tobacco use date to the Mayans in Pre-Columbian times. Subsequently brought to Spain by Columbus, it gained popularity in Western Europe during the sixteenth and seventeenth centuries as something to be chewed or smoked in a pipe. The cigarette was not introduced until the 1840s, but by the early decades of the 1900s, cigarette smoking had gained wide acceptance in the Western world (1). Cigarette smoking in the United States likely peaked sometime between 1955 and 1965 at over 40% of the adult population, but it has since declined in all socio-demographic subpopulations to approximately 16.8% of US adults (2) and 14% of high school students (3). Unfortunately, worldwide consumption of tobacco has continued to grow with over 1 billion active users at present (4).
