NEW YORK, Apr 12 (Reuters Health) -- Although most people think that car accidents are the leading cause of premature death in the US, smoking is actually the number one cause, followed by obesity and a sedentary lifestyle, according to a new report.

 If lawmakers focus their efforts on these problems and a handful of others -- a total of nine -- they could prevent 1.6 million premature deaths in one decade, and save over $145 billion in national health costs per year in the process. Currently, more than 1,000 health policy bills are under consideration by the US Congress.

 "The health agenda is quite broad and there's a lot of noise -- a lot of lobbyists and advocates out there -- and we know that resources are limited. So what we've done is focus on the opportunities to save lives and help people," said Ashley Coffield, president of Partnership for Prevention (PFP), a non-profit, non-partisan Washington, DC-based organization, which conducted the policy analysis.

 The report, which was commissioned in 1998 by a bipartisan group of 60 lawmakers called the Congressional Prevention Coalition, was released on March 30th. It contains data accumulated from interviews with over 80 health policy experts as well as a review of the effectiveness of legislation at local and state levels.

 Turning a blind eye to any potential political roadblocks, the group winnowed down 200 public policy options to a final list of nine by only considering the health burden on the US population.

 Among the major health issue areas cited are gun control, alcohol abuse, tobacco use, water supply fluoridation, overweight children, and federal entitlement program health coverage. Particular policy initiatives include:

 -- enactment of a state-run national handgun licensing and registration system;

 -- enactment of uniform national drinking and driving laws with 0.08% blood alcohol content as the legal limit, and an increase in the federal tax on alcohol;

 -- increasing federal tobacco taxes and banning smoking in all enclosed public spaces;

 -- enacting financial incentives for states to require secondary public schools to have physical education classes;

 -- enacting financial incentives for states to develop water fluoridation systems;

 -- and requiring entitlement programs like Medicare to cover preventive care services with caps on co-pays and deductibles.

 Such initiatives can prevent the most disease, injury and premature death for the least amount of money.

 Although the report does break down projected policy costs and numbers of lives that could be saved per policy, it does not rank the problems or the recommended solutions in order of importance -- with many people affected by more than one issue simultaneously.

 In an interview with Reuters Health, Coffield said the goal of the report was to come up with practical solutions to a complex set of issues. This is important both for Congress and the American public -- two other recent PFP studies found that many people are misinformed about the major health hazards in the US. While smoking is the leading cause of premature death, only 23% of those surveyed listed it as the number one killer (causing 400,000 deaths annually). In addition, only 9% believe that obesity/sedentary lifestyle is a leading cause of premature death. In fact, it is second only to smoking and causes 300,000 deaths annually.

 For lawmakers, in particular, Coffield thinks the report can be a critical and helpful guide. "Congress has a lot of things on the table and hundreds of organizations have prevention on their agendas," she said. "So it follows that a comparison of prevention policies is helpful. It helps give lawmakers an indication of what to do first. Where can you get the most bang for your buck?"