In a landmark report by the U.S. Surgeon General in 1964, the government warned its citizens of the adverse effects of smoking on their health and took a series of steps to discourage smoking. These steps stemmed from “ordinary politics” –that is, actions taken or authorized by legislatures. 1994 heralded a new era in tobacco politics: of “adversarial legalism,” wherein state attorneys general sued leading cigarette manufacturers for the harm they had done to public health. These law-suits culminated in the Master Settlement Agreement (MSA) that directed an estimated $250 billion to state governments over the next 25 years and imposed new marketing and advertising restrictions. In her second edition, Martha Derthick introduces new evidence from 5 years of experience under the MSA to show that the states were more interested in raising revenue than in improving tobacco control, that the enrichment of wealthy tort lawyers violated the legal profession's ethics, and that the agreement, ironically, spawned the rise of small, upstart cigarette manufacturers able to undersell the major companies. In this clearly written, fast-paced case study, Derthick concludes that the tobacco lawsuits not only produced flawed public policy that flouted the American system of checks and balances, but has done little to improve or better safeguard public health.

This book comprehensively covers the science and policy issues relevant to one of the major public health disasters of modern times. It pulls together the aetiology and burden of the myriad of tobacco related diseases with the successes and failures of tobacco control policies. The book looks at lessons learnt to help set health policy for reducing the burden of tobacco related diseases. The book also deals with the international public health policy issues which bear on control of the problem of tobacco use and which vary between continents. The editors are an international group distinguished in the field of tobacco related diseases, epidemiology, and tobacco control. The contributors are world experts drawn from the various clinical fields. This major reference text gives a unique overview of one of the major public health problems in both the developed and developing world. The book is directed at an international public health and epidemiology audience includng health economists and those interested in tobacco control.