Healthy People 2020 and Tobacco Use The Healthy People 2020 initiative provides a set of goals to improve the health of American citizens. The science-based goals set out ten-year targets to be achieved by 2020 across a wide range of health issues. One health issue included in the initiative is tobacco use with a target to reduced tobacco use to a "point that it is no longer a public health problem" (DHHS, 2012).

Over the last forty years there ahs been a wealth of research examining the health impacts associated with the use of tobacco, with tobacco use being cited as being the single most preventable cause of death in the United States (DHHS, 2012). Tobacco has a negative impact on those who smoke as well as those who do not smoke but are exposed to the second hand smoke. The health problems associated with tobacco use in cancer, heart disease, lung diseases and when the tobacco is used by a pregnant mother there are also risks of premature births, low birth weight and still births (DHHS, 2012).

The problem is not only the proven causation link, but the scale of the problem. For example, the World Health Organization (WHO found that in the U.S. It 80% of women and 90% of women diagnosed with lung cancer contract the result as a direct result of smoking

(WHO, 2003). This is significant as the CDC estimated...

Furthermore lung and bronchus cancer were the second most prevalent cancer in the U.S. (CDC, 2012). Overall, it is estimated that in the U.S. 443,000 people die every year as a direct result of tobacco use (CDC, 2005). The problem is not only seen in terms of mortality, but also morbidity, as it is estimated that for every death another 20 people are suffering at least 1 serious tobacco related illness (DHHS, 2012). The financial cost is also high, it has been estimated that the total annual health costs associated with smoking amount to $96 billion, with $4.98 billion associated purely with second hand smoke exposure (Guilfoyle, 2011).
When looking at the risk factors tobacco use of an action that is undertaken initially as a result of a personal decision. However there are a number of factors which may impact on that decision. With many individuals taking up smoking while still at school it is notable that social pressures appear to have an impact, research indicates those exposed to smoking by parents, siblings and friends show an increased probability of taking up smoking (Frieden, 2004). The behavior in terms of smoking may also impact on the health risks; the…