Editor's note: Kathleen Sebelius is the United States secretary of Health and Human Services.
Washington (CNN) -- Across the country, we are landing major blows in our fight to reduce tobacco use and save lives. Earlier this year, North Carolina, which grows more tobacco than any other state, banned smoking in bars and restaurants.
On Friday, my home state of Kansas became the 24th to pass a comprehensive smoke-free law, covering not just bars and restaurants but other workplaces, too. And this week, as part of major anti-tobacco legislation signed by President Obama in June, I signed a long-awaited rule outlawing many of the approaches tobacco companies use to bypass existing laws and market their products to young Americans.
Because our anti-smoking policies have been so successful over the past 50 years, it can be easy to think of tobacco use as a problem that is going away on its own, like a cut healing over time. Yet in recent years, youth and adult smoking rates that had been dropping for decades have stalled.
Over half a century after the U.S. government first acknowledged the connection between smoking and lung cancer, more than 8.5 million Americans have a serious illness caused by smoking. And 443,000 Americans die prematurely each year from smoking or secondhand smoke, making it our country's leading cause of preventable death.
Despite these well-known health risks, tobacco companies continue to recruit their next generation of lifelong customers. Every day, nearly 4,000 kids under 18 try their first cigarette, and about 1,000 kids under 18 become daily smokers. Many of them start smoking without knowing or thinking about the health consequences. And because nicotine is one of the most addictive drugs we know of, many of them keep smoking long after they wish they'd never started. Nine out of 10 adult smokers begin smoking in their teens or earlier.
That's why the new rule, which is being published in the federal register today, is so important. The 1998 settlement between states and tobacco companies forbids those companies from marketing their products to children and from advertising on billboards and buses. But since then, overall spending on activities to promote companies' brands has actually risen 85 percent to $12.8 billion a year.
And tobacco companies have made sure that many of those promotions and ads catch the eyes of our children. The three brands that spend the most on advertising and promotion -- Marlboro, Camel and Newport -- are preferred at higher rates by children than by adults.
In 2007, for example, R.J. Reynolds created a new variety, Camel No. 9, supposedly targeted at adult women. Yet the brand's launch included events with kid-friendly giveaways, like berry-flavored lip balm and cell phone jewelry, each of which had a recognizable pattern of colors identifiable with the Camel No. 9 brand.
When researchers surveyed 10- to 13-year-old girls before and after the marketing campaign about their favorite cigarette brands, they found that the share of girls who said they preferred Camels had gone up 60 percent.
Under the FDA's new rule, these kinds of advertising campaigns will now be illegal.
The rule will end similar giveaways and sponsorship of concerts or sporting events using a tobacco product's brand name or logo. It will prohibit advertising strategies that have been shown to appeal to youth, like giving away hats or T-shirts with tobacco brands or logos. It will also forbid the sale of cigarettes or smokeless tobacco in vending machines, except in very limited situations. And it will make it illegal to sell cigarette packages with fewer than 20 cigarettes, often called "kiddie packs."
This rule contains the most significant new regulations on tobacco companies since the 1998 settlement, but it is just a start. It's estimated that about 6 million children alive today will eventually die from smoking-related diseases unless we continue to reduce smoking rates, and this is not a job for the federal government alone.
The states must continue to play an aggressive role. I hope that other states will follow the examples of North Carolina and Kansas so that no employee has to risk his or her life by working in a haze of secondhand smoke.
And cities and towns, which see the costs of smoking up close, can contribute, too. Today my department will announce $142 million in grants that will fund proven local strategies for reducing tobacco use in 21 communities across the country.
This needs to be a national effort. The lesson that we should take from the successes of the past 50 years is not that progress is inevitable. It's that saving lives and reducing health costs is possible, but only if we pursue an aggressive policy agenda.
We've come a long way since the days of smoking on planes and in elevators. But we have a long way left to go. If smoking rates aren't moving, especially among young Americans, we need to. The prosperity and health of our country depends on it.
The opinions expressed in this commentary are solely those of Kathleen Sebelius.