Gage Skidmore
Health + Tech /05 May 2019
05.05.19

Would a Higher Tobacco Minimum Buying Age Deter Use?

Bipartisan legislation is rare enough in the U.S. that when it does arrive, it’s only right to ask questions like, “Will it work?” and “What’s the catch?” Nevertheless, Democrats and Republicans in the House and Senate stand together in support of the “Tobacco to 21 Act,” which seems to have far more upsides than downsides. Let’s take a look at what the Act would do — and whether it may produce its intended effect: namely, curbing smoking and tobacco use among young people.

What Does ‘Tobacco to 21’ Hope to Accomplish, and How?

The bill was introduced in the House of Representatives by Diana DeGette and Chris Stewart, and in the Senate by Brian Schatz and Todd Young. There are two main goals of this legislation:

  • Raise the minimum age to 21 for the purchase of all tobacco product categories, including e-cigarettes, cigarettes, and cigars.
  • Legally prohibit all tobacco retailers from selling such products, without photo identification, to customers who appear to be under the age of 30.

Presently, federal law prohibits the sale of such products to anybody under the age of 18. But American states are “laboratories of democracy,” and that means some of them have their own ideas when it comes to the smoking and purchasing ages for tobacco. As of April 2019, 12 states had already raised their smoking and/or purchase ages to 21. More than 400 counties and cities within states that have chosen not to have done so on their own.

That means the ‘Tobacco to 21 Act’ isn’t exactly a novel idea — but it’s an overdue adjustment at the federal level to help eliminate some of the inconsistencies in America’s patchwork of tobacco laws.

Representative DeGette was clear about her own motivations in co-sponsoring the bill: “Unlike other bills drafted by the industry, our bill has no special-interest carve-outs or limitations on state and local governments…Unlike other bills, our bill was drafted with one simple goal in mind and that’s to protect public health by keeping tobacco products out of the hands of young people.”

Multiple public advocacy and health groups have signaled their support for the legislation, including the American Academy of Pediatrics, the Campaign for Tobacco-Free Kids, the American Heart Association and the American Cancer Society Action Network.

Why the Push to Raise the Smoking Age? Does It Work?

America is fast approaching a reckoning with the fact that cigarettes and alcohol are fairly loosely regulated while marijuana, which more and more resembles a medicine the longer we study it, remains a Schedule 1 drug at the federal level. The truth about smoking’s widespread and ghastly impact on public health means ‘Tobacco to 21’ is long overdue. According to research, we know that:

  • Smoking causes 7 million preventable deaths, worldwide, per year, making it the leading cause of preventable death throughout the world.
  • At least 16 million Americans currently live with a smoking-related disease.
  • Smoking is proven to weaken the immune system and cause cancers of the mouth, throat, and lungs, lung and heart disease, emphysema and other conditions, and greatly raises a smoker’s likelihood of developing rheumatoid arthritis, tuberculosis, vision problems, and even erectile dysfunction.
  • On average, tobacco users see their lifespans cut short by 10 years compared with non-smokers.

The CDC also indicates that if we don’t find ways to curb our smoking habits, the worldwide annual death toll could rise to 8 million preventable deaths by 2030. And here’s one more data point hiding in the CDC’s fine print:

If youth smoking rates remain unchanged, 5.6 million minors in America today will die early from a smoking-related condition. That’s one out of every 13 American children. How many Facebook friends does your son or daughter have? This is math no parent should have to perform.

The question is: does legislation like this actually work?

The answer in scientific circles is “yes.” Here’s the word on raising the smoking age to 21, straight from the National Institutes of Health:

  • Some 90% of adult smokers had their first cigarette before their 18th birthday.
  • About 90% of tobacco products purchased for minors are bought by individuals between the ages of 18 and 20.
  • There is compelling evidence that raising the legal age for tobacco products coincides with a reduction in smoking among minors and young adults. This has been observed in England (a 30% reduction) and Sweden (the success rate of attempted underage purchases of tobacco products fell from 84% to 48%).

Moreover, the NIH estimates that if this change takes place at the federal level in the U.S., rates of tobacco use among minors aged 15-17 should be expected to drop from its present 22% to under 9% inside of seven years.

There seems little downside. And that leaves just one question.

Is There a Catch?

As Representative DeGette hinted, some members of the American Senate have “other bills” they favor instead. Enter Addison Mitchell (“Mitch”) McConnell, Jr.

Mitch McConnell hails from Kentucky, which is one of the biggest producers of tobacco in the country. It is an open secret that he has received more than $160,000 in campaign donations from a company called Altria, which is one of the biggest manufacturers of cigarettes in the world. That should make his motivations immediately suspect.

The 77-year-old Senate Majority leader calls youth consumption of nicotine products — and vaping products especially — an “epidemic” and has promised to make it a “top priority” to introduce legislation of his own which would raise the age to 21, just like “Tobacco to 21” proposes to do. So why isn’t he signing on to this existing legislation? Why go to the trouble of drawing up a different proposal altogether? As Representative DeGette alluded to, it’s all about the “special interests.” And given McConnell’s list of campaign donors, we know precisely whose interests he tends to “prioritize.”

According to John Schachter from the Campaign for Tobacco-Free Kids, McConnell and his friends in the tobacco industry are “turning these Tobacco 21 bills into Trojan horses.” He continues: “The industry is positioning Tobacco 21 as the only thing that needs to be done on tobacco prevention…it needs to be a compliment [to other measures].”

Professor Rob Crane, of Ohio State University, is even more worried about McConnell’s motivations: “the hair on the back of my neck stood up and I said, ‘this is really terrible.’” More specifically, professor Crane has observed the state-by-state ban on flavored e-cigarettes and sees such measures as a far greater existential threat to tobacco company profits than raising the purchasing age. Youth use of flavored “e-cig” products skyrocketed by almost 80% in the course of a year. Any casual observer should recognize this product family as Big Tobacco’s greatest weapon for grooming the next generation of addicts.

Schachter and Crane worry that McConnell’s incoming “Tobacco 21” bill will be loaded with amendments and fine-print prohibiting states and cities from banning flavored products, or raising cigarette taxes, in exchange for raising the purchasing age. In McConnell’s home state of Kentucky, lawmakers “mysteriously” dropped an e-cigarette tax from their budget at the 11th hour.

As Representative DeGette indicated, the original “Tobacco to 21” bill does not contain industry-friendly language. By all appearances, it seems to be a good-faith effort to curb rates of youth tobacco use — and it stands on a solid, research-backed foundation. This conversation has clearly gone mainstream, but whether it survives lobbying intervention and the conflicts of interest of ethically compromised politicians remains to be seen.

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