Authorities in the US aim to halve smoking among young people in seven years through curbing access to cigarettes and severely restricting advertising.
The move, initiated in August 1996 by the US Food and Drug Administration, was prompted by its "far-reaching study of the tobacco industry which concluded that cigarettes were drug delivery devices". It concluded that smoking is a paediatric disease.
It also reinforced the scientific view that smoking is addictive, according to Ms Judith Wilkenfeld of the FDA's health and human services.
She told a conference attended by more than 2,400 lung cancer specialists that a key finding enabling the FDA's new restriction to stand up to court challenge was that cigarette companies knew nicotine was a drug affecting the structure and function of the body.
Companies had evaluated nicotine absorption and "how much was needed to satisfy smokers". The FDA investigation established that since 1982, tobacco companies were increasing nicotine levels in cigarettes as they were reducing tar levels.
This ran counter to their public statements that with decreasing tar came reduced nicotine.
The motivation to restrict access to cigarettes and smokeless tobacco came, she said, from the finding that tobacco-related deaths exceeded the total associated with AIDS, motor accidents, homicides, alcohol, illegal drugs, suicides and fires.
Children were found to be well-briefed on the dangers of smoking, but believed it did not apply to them. The move against advertising followed the finding that close to $5 billion has been spent in recent years by the tobacco industry promoting its product, making it among the most-heavily promoted in the US.
The FDA's new rules prohibit the sale of tobacco to anyone under 18 years and require retailers to check photographic identification for everyone under 26. Cigarette vending machines are no longer permitted in public places, except where people over 18 congregate.
Outdoor advertising is restricted, particularly near schools and playgrounds. Print advertisements are in most cases allowed only in black and white text. Tobacco companies may use only their corporate name, as opposed to brands, in sports sponsorship.
Many established promotion techniques are banned. These include using adults and children "as walking billboards" by having brands on T-shirts or sports bags.
Unannounced inspections of tobacco retail outlets, using adolescents attempting to buy cigarettes, are being introduced, Ms Wilkenfeld said.
The rules may be subjected to sustained court challenges but these will be met by the FDA. "Tobacco control will never go back to what it was," she said.
