This issue of the American Journal of Preventive Medicine examines factors associated with youth tobacco use–a timely topic given that this year is the 50th anniversary of the first Surgeon General’s Report on Tobacco. In 1960, the outlook was grim. The probability that a boy born in 1960 would be smoking by the time he was 20 years old was about 35%.1 After more than a dozen Surgeon General’s Reports describing the health consequences of tobacco use, the youth smoking rate in 1991 was still 27.5%.