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Boost the Smoking Age

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Guest Dwight C

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A Local Push to Boost the Smoking Age

NEARLY 350 CITIES AND communities in the United States have opted to increase the minimum legal sales age for tobacco products – including e-cigarettes – from 18 to 21.

On Monday, San Antonio, Texas, became the first city in the Lone Star state and 341st locality in the U.S. to enact a Tobacco 21 ordinance, 13 years after Needham, Massachusetts, became the first town to increase its minimum smoking age in 2005. The localities that have already bumped the age limit up range from big cities like Chicago and New York City to small cities and counties like Garden City, Kansas, and Adams County, Mississippi.

"It's kind of like a little series of wildfires spreading around the country, and I say we're the cheerleaders," says Dr. Rob Crane, a Ohio State University clinical professor in the family medicine department and president of the Dublin, Ohio-based Prevention Tobacco Addiction Foundation, which runs the national Tobacco 21 campaign.

At the end of December, Massachusetts will join five states – Hawaii, California, New Jersey, Maine and Oregon – as well as Guam and Washington, D.C. in enacting a law that bans the sale of tobacco products to anyone under the age of 21. Crane says the Tobacco 21 legislation also pushes for a change in enforcement, from police to public health departments, to more effectively limit nicotine initiation.

Opponents to the age limit change say that it will hurt small businesses and local tax revenue as well as breach personal freedoms of young adults who, at the age of 18, have the ability to vote and join the military. Despite 26 municipalities already enforcing the higher age limit, Illinois Gov. Bruce Rauner struck down a statewide ordinance in August to raise the minimum smoking age.

"Unfortunately, this legislation will inhibit the choice of consumers while also not helping keep tobacco products out of the hands of youth," Rauner said in his veto message, the State Journal-Register reports. "Raising the age people can purchase tobacco products will push residents to buy tobacco products from non-licensed vendors in neighboring states. Since no neighboring state has raised the age for purchasing tobacco products, local businesses and the state will see decreased revenue while public health impacts continue."

But, Crane says, every age restriction limit, whether for alcohol or casino gambling, is set by policymakers and citizens to protect the public.

"I'm sure there are plenty of 14 year olds who can drive a car fine, but we have to decide on an arbitrary maturity level that we think best fits the likelihood of them being ready," he says. "For those things which we think are riskier – like handgun purchase: 21; alcohol purchase: 21; being a foster parent in almost every state is 21; casino gambling in almost every state is 21 – it's a thoughtful attempt to pair responsibility with increasing maturity, and I think every parent gets that."

A 2015 study from the Institutes of Medicine found that raising the legal age for tobacco product purchase to 21 nationwide would result in "approximately 249,000 fewer premature deaths, 45,000 fewer deaths from lung cancer, and 4.2 million fewer years of life lost" for people born between 2000 and 2019, as well as "approximately 286,000 fewer preterm births, 438,000 fewer cases of low birth weight, and roughly 4,000 fewer sudden infant death cases among mothers age 15 to 49." Most daily smokers – 90 percent – reportedly began smoking before the age of 19, according to the study. 

The widespread push comes almost 35 years after then-President Ronald Reagan lifted the drinking age from 18 to 21 and amid a flurry of studies showing a rise in e-cigarette use among teens despite overall youth tobacco use declining in recent years.

On Tuesday, the Rand Corporation, a nonprofit research organization, released a three-year studybolstering evidence of e-cigarette and cigarette use among teens leading to a reciprocal increase in use of both products over time. 

U.S. Food and Drug Administration Commissioner Scott Gottlieb in September referred to the annual growth in e-cigarette use among teenagers as "an epidemic" that threatens to create a new generation of people addicted to nicotine.

"The disturbing and accelerating trajectory of use we're seeing in youth, and the resulting path to addiction, must end. It's simply not tolerable," Gottlieb said in a department-issued statement.

Earlier this year, the FDA announced its Youth Tobacco Prevention Plan, which intends to curb marketing at youth, prevent underage access and educate teens about "the dangers of using any tobacco product, including e-cigarettes." Two days ago,

As of 2017, more than 3.6 million middle and high school students were current tobacco users, and e-cigarettes have been the most commonly used tobacco product among both groups since 2014, according to the Centers for Disease Control and Prevention

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