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Tobacco companies have spent increasing amounts of money on marketing efforts to reduce prices, which health officials said in the report could influence access to price-sensitive youth and make cigarettes more affordable. Nearly $10 billion was spent in 2008 on cigarette marketing by the nation's five biggest tobacco companies, a 48 percent increase from what was spent in 1998, when some of the companies agreed with state attorneys general to curtail or stop some of their marketing efforts. The surgeon general's office last issued a report on youth tobacco use in 1994, the first wide-ranging report on the topic by federal health officials. The new report is the 31st issued by U.S. surgeons general to warn the public about tobacco's risks. The first report in 1964 declared tobacco to be deadly. "We have come a long way since the days of smoking on airplanes and in college classrooms, but we have a long way to go," Secretary of Health and Human Resources Kathleen Sebelius said in a statement accompanying the latest report. "The prosperity and health of our nation depend on it."
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