ABSTRACT
At his 70th birthday speech in 1905, Mark Twain said, “I have stopped smoking now and then…but it was not on principle, it was only to show off. It was to pulverize those critics who said I was a slave to my habits and couldn’t break my bonds.” The plight of Mark Twain is experienced by the millions of Americans who have attempted to quit smoking. While it was hoped in 1990 that the year 2000 would see a smoke-free America, the decrease in smoking prevalence has leveled off among Americans. Between 1990 and 1993, the prevalence of smoking remained stable at 25% after a 25-year decline. Smoking prevalence actually increased over 4 years until 1995 among ninth and tenth graders and over the same 3 years for high-school seniors (1).
