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Diana Chapman Walsh Health Policy Institute, and School of Public Health, Boston University, Boston, Massachusetts 02215 Nancy P. Gordon Division of Health Policy, Research, and Education, Harvard University, Cambridge, Massachusetts 02138 As a target of opportunity for public health action, smoking stands alone. The scientific indictment has been so compellingly constructed that it exemplifies how painstaking research can weave around an initially observed correlation, strand-by-strand, a web of causation so ineluctable that all it lacks is "a signed confession from the cigarette" (5). The health and human costs are so clear that most of the 55 million cigarette smokers in the United States freely voice the wish that they could stop. The economic trade-offs are so stark that the present lifetime value of quitting for heavily smoking men under age 45 is about $34,000 in reduced risks of lung cancer, coronary heart disease, and emphyse ma alone, according to one estimate (47a). And the political situation has evolved to the remarkable point where the Secretary of Health and Human Services in a most ardent free market and antitax administration could float the proposition that the government exact a kind of users' tax on cigarettes, to aid in the
Annual Review of Public Health – Annual Reviews
Published: May 1, 1986
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