Tobacco use is considered the chief preventable cause of death in the United States with over 20% of all deaths attributable to tobacco use. Cigarette smoking is responsible for heart disease; cancers of the lung, larynx, mouth, esophagus, and bladder; stroke; and chronic obstructive pulmonary disease. In addition, there is evidence that cigarette smokers are more likely to drink alcohol and use marijuana and cocaine as compared to non-smokers. If current patterns of smoking behavior persist, an estimated five million U.S. persons who were aged zero to 17 years in 1995 could die prematurely from smoking-related illnesses. In 1996, the Food and Drug Administration issued regulations to implement the 1993 law known as the Synar Amendment, which restricts the sale and distribution of cigarettes and smokeless tobacco to children and teenagers under age 18. Over 80% of school districts prohibit tobacco use in the school building and on the grounds at all times.