The Department of Health and Human Services (HHS) set a goal to reduce tobacco use which kills an estimated 443,000 people in the U.S. each year and costs the U.S. $96 billion in medical costs and $97 billion in lost productivity each year. Despite progress in reducing tobacco use, the decline in adult smoking rates had stalled, coincident with reductions in state investments in tobacco control programs. In response, an Agency Priority Goal at HHS expanded from initially tracking the percentage of communities that adopted smoke-free policies to a goal to reduce nationwide cigarette consumption per capita. Shifting the agency’s focus from policy adoption to reducing cigarette use has helped to accelerate progress and included a broader set of contributing programs to execute the comprehensive tobacco control strategy. The strategy was designed to mobilize the agency’s expertise and resources in support of proven, pragmatic, achievable actions that can be aggressively implemented at the Federal, State, and community levels. In FY 2012, annual per capita adult cigarette consumption decreased to 1,196 per capita from a level of 2,076, representing a 42 percent-decrease over 12 years.