The American Cancer Society has been a leader in the war against tobacco. To find out about the Society's future plans, the following is an interview from  Dr. Dileep G. Bal, the Society's national president.

Q. Cigarettes kill more than 400,000 Americans every year, more deaths than from AIDS, alcohol, car accidents, murders, suicides, drugs and fires combined. What can be done to decrease these numbers?
A. I think we have to do more to stop kids from starting. We must take the industry head-on, even though it is difficult and the tobacco industry has tremendous resources. It spends over $5 billion each year marketing its products and millions more on public relations, political contributions and lobbying. We need to approach smoking from a public health perspective as well as a personal one that says to a young person, here are the risks if you smoke. Laws like the one we have in California that bars smoking in most public settings including restaurants and workplaces are important, because they decrease the number of places kids can smoke.

Q. Since 1988, California has experienced the greatest impact of all states with a 50 percent decline in tobacco use, compared to 30 percent for the country as a whole. What part in that reduction have the high taxes on cigarettes played?
A. A major role, especially in decreasing smoking rates among young people and low-income adults. In 1988, voters passed Proposition 99 that added a 25-cent-per-pack surtax on tobacco products to finance anti-smoking programs. Surtaxes like that put tobacco products beyond the reach of many kids who don't have much disposable income. Studies show that a 10 percent increase in the price of cigarettes can lead to a 6 to 10 percent decrease in the smoking rate of kids and a 3 to 5 percent rate for adults. Discouraging young people from smoking is crucial, because every day 3,000 kids begin smoking regularly.

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Q. Each year children smoke more than 920 million packs of cigarettes, resulting in about $500 million in profits for the cigarette companies. Underage smokers find it easy obtain cigarettes. Any solutions?
A. About half of all underage smokers usually buy the cigarettes they smoke either directly from retailers or vending machines or give money to others to buy them. Other kids get their cigarettes for free from older smokers or even steal them from their parents. What we need is to make it impossible for underage smokers to obtain cigarettes. Voluntary compliance programs, such as those promoted by the big cigarette companies, don't work. In some places, cigarette sales represent 70 percent of the sales and 50 percent of the profits of mom-and-pop stores, so there is a big financial incentive for these places to sell to children. On the other hand, laws against cigarette sales to kids do work. Regular compliance checks and fines can significantly reduce youth smoking. Massachusetts has made strong enforcement of youth access a priority. Officials conduct regular sting operations and fine violators. As a result, illegal retail sales have dropped from 48 percent to 8 percent.