This article is the second in a series of four providing current, state-of-the-art information about the tobacco problem and how physicians can effectively intervene. It provides an historical perspective of the issues surrounding environmental tobacco smoke in the United States. The remaining three manuscripts in this series offer free continuing medical education credits for physicians via www.pedseducation.org. Please refer to the first article in the April edition of the Delaware Medical Journal and upcoming articles in the June and July issues for further information.