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1 preventable cause of disease and death in the United States, and that a rise in youth smoking is one of the most alarming trends in the tobacco epidemic. Goals for Be The First include: Contributing to a 3 percent decline in the national youth smoking rate 10 percent decline in the number of new youth smokers Doubling the number of tobacco-free college and university campuses We are at a critical moment in our nations efforts to end the epidemic of tobacco use that continues to kill more people than any other preventable cause of death, and threatens the health and well-being of our next generation, Dr