Tobacco use and passive exposure to tobacco smoke are the most important environmental health hazards in the United States. Over 400 000 deaths each year are attributed to smoking and using other tobacco products.1 Although most of these deaths are in adults, in recent years the pediatric morbidity of tobacco use has received increasing attention. In 1992 the Environmental Protection Agency published Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders, which highlighted the adverse effects of passive smoke exposure on children.2 The Surgeon General's Report of 1994, entitled Preventing Tobacco Use Among Young People, provides a comprehensive review of the impact of cigarette smoking on youth.3

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