The rate of cigarette smoking among U.S. adults has declined substantially during the presidency of Barack Obama, according an article published in the New England Journal of Medicine. Author Michael Fiore, M.P.H. ’85, writes that since 2009, smoking rates have dropped about 0.78 percentage points per year and are now at 15.3 percent. If this rate of decline continues, smoking prevalence will fall to zero by around 2035.

“This progress has made the total elimination of tobacco use in the United States seem possible, rather than merely aspirational,” Fiore wrote in a Perspective piece published Aug. 17, 2016. He credits the tobacco-control interventions implemented during the Obama years at the federal, state, nonprofit, and private-sector levels. These include new laws increasing the federal cigarette excise tax rate from $0.39 to $1.01 per pack, and giving the Food and Drug Administration (FDA) the authority to comprehensively regulate tobacco products.

Fiore highlighted the efforts of Howard Koh, professor of the practice of public health leadership at Harvard Chan School, who served from 2009 to 2014 as the 14th assistant secretary for health for the U.S. Department of Health and Human Services (HHS). During his tenure, Koh led the effort to develop the first HHS comprehensive tobacco prevention plan and created the HHS Tobacco Control Steering Committee, which coordinated departmental actions designed to reduce tobacco use.

Fiore also offered several recommendations for further reducing tobacco use, such as raising the legal age for purchasing tobacco products to 21, and implementing comprehensive indoor smoking bans.

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