I was happy to see the Nov. 21 Tribune editorial "Smoking a Nasty Cycle." I am writing to add some comments about Measure No. 3, and to clarify one expectation of the new program.

North Dakotans voted to approve Measure No. 3 to fund tobacco control programs to CDC-recommended levels. The initiative includes establishing a committee dedicated to developing a plan to implement comprehensive, evidence-based tobacco control programming that meets the recommendations from the CDC Best Practice Guidelines.

The article correctly provided an overview of the problem in North Dakota: Each year, 700 youth initiate tobacco use, and 900 die in North Dakota from tobacco-related causes. In addition, health care costs associated with tobacco use impact the state to the tune of $247 million per year.

My only concern is that the article created the expectation that, within less than a year of launching the program in North Dakota, "the numbers of high school-aged smokers will have declined significantly." Yes, we can and will look for a decrease in high-school-age smokers, but it won't happen that quickly.

It is important to realize that it will take more than a few months of concentrated effort to "undo" the complicated network of tobacco-accepting social norms that the tobacco companies have spent 90 years or more to create. Also, since this is a brand-new initiative, it is possible the advisory committee's implementation of programs may just be getting started by the end of 2009.

What can you look for in the state of North Dakota? First, look for increased availability of free cessation medications and cessation programs. Look for increasing awareness that smoking is not the cool, sexy thing the tobacco companies make it out to be. Then, look for increased quit rates among all North Dakotans and fewer young people taking up the habit.

You can positively count on better health in North Dakota as a result of comprehensive tobacco control programming. States that have implemented programs based on CDC's best practices have seen just that.

The article ended with this statement, "It's another hard road ahead, but one worth taking." I couldn't agree more, because the new program will deliver tremendous benefits to the state. It will reduce tobacco use. That means it will reduce the deaths, heart diseases, cancers, and other lung diseases caused by tobacco use.

We will need to give it time.