The review of the history of crack cocaine notes that when placed in the context of the history of drug use in the United States, crack cocaine use and the epidemic of the mid-1980s apparently furthered episodes in the persistent search for more intense drug experiences by young adult and adolescent populations. Its distinctive dangers lie in its being cheap, addictive, and associated with dramatic psychological, physiological, and social consequences. The overall decline in both licit and illicit drug use in the United States over the last decade has been countered by the fact that the number of current crack cocaine users has remained constant. Because the crack cocaine epidemic is concentrated in the inner cities and because smoking cocaine is unusually addicting, the exception of crack cocaine to the general pattern of drug abuse epidemiology is especially important. The challenge to its prevention is to address these concerns. The campaign to prevent the use of crack cocaine must be mounted on several fronts. Educational efforts that target youth at high risk of becoming users should be continued and expanded to include new information about the characteristics of both the drug and the high-risk populations. The attraction of crack cocaine for women, especially those of childbearing age, must be a major focus of prevention efforts. Prevention programs must include parents, health-care providers, schools, the media, the workplace, and the community. In addition, there must be continued research that assesses the efficacy of prevention efforts, which is essential for improving the use and outcomes of prevention techniques. 5 tables