Smoking remains the number one preventable cause of death in the United States and other developed countries and costs trillions of dollars due to health problems and lost productivity. About 80% of all smokers report beginning to use tobacco before 18 years of age. Each day in the United States, approximately 6000 adolescents try their first cigarette, 3000 or more of them become daily smokers, and about 1000 of these will eventually die from tobacco-related causes. Primary prevention efforts in the past five years have been successful in reducing tobacco initiation and tobacco-use rates in adolescents. At the core of these efforts have been school-based prevention curricula and community anti-tobacco media campaigns. This book reviews 30 years of controlled studies on tobacco use prevention in adolescents and provides conclusions about which interventions have been most effective. This review focuses on school-based prevention programs, but also examines multifaceted, community-wide interventions; media messages and campaigns; and prevention issues in minority youth. This review concludes by highlighting important issues to consider when implementing school-based tobacco use prevention programs. The book then extends its discussion of effective youth tobacco use prevention interventions by illustrating how these effective components have been used in the implementation of statewide, comprehensive tobacco use prevention and control programs including in California, Massachusetts, Arizona, Florida, Oregon, and Mississippi.