Author: Catherine Troisi
Tobacco products are a known cancer-causing agent and responsible for one in three cancer deaths. Smoking kills more people than alcohol, AIDS, car crashes, illegal drugs, murders and suicides combined — and thousands more die from smoking-related causes such as fires caused by smoldering cigarettes. E-cigarettes, often touted as a safer alternative, have not been well-studied and may contain unknown poisons.
We are not protecting our children from this danger. Unlike alcohol sales, where you have to be 21 years to purchase legally, adolescents and young adults 18 and over can purchase tobacco products. While the Texas Legislature wisely raised the age to buy e-cigarettes from 14 to 18 years last year, it’s time to look at raising the legal age for all tobacco products to 21.
The problem is not just those age 18 and older smoking. This young legal age to purchase makes it easier for children under age 18 to get access to cigarettes and other products. Each year, 19,000 Texas children under the age of 18 start smoking. In Texas, almost one out of every six high school students smokes — and over their lifetime, half a million Texans who started smoking under age 18 will ultimately die of tobacco-related diseases.
Most of us have someone in our family or know someone who has been affected by a tobacco-related disease. A colleague lost both parents and his only sibling as a result of smoking that began when they were teens. Each relative suffered for over a decade before finally succumbing to the effects of tobacco. His brother was 46 when he was diagnosed with oral cancer. Cancer took his jaw, tongue, teeth and ability to speak clearly and swallow. He suffered for 13 years before it took his life.
There’s also an economic impact. Smoking by children under age 18 costs the state almost $9 billion dollars in direct costs and each Texan household’s federal tax is increased by $756 per year, according to reports from the Campaign for Tobacco-Free Kids. Imagine what we could do with that money both as a state and as individuals rather than use it for tobacco-related medical costs.
The tobacco industry knows that nine out of 10 smokers start before age 18 — and each day 3,200 children smoke their first cigarette. An estimated $636 million is spent on marketing to sell their harmful products just in Texas. Children are twice as sensitive to tobacco advertising as adults and more likely to be influenced to start smoking by these marketing tactics than they are by peer pressure. Tobacco companies have to get children smoking by age 18 — otherwise the odds that they will start are small.
Would raising the legal age to purchase actually stop children from getting these products? The tobacco company Phillip Morris thought so in a 1986 report: “Raising the legal minimum age for cigarette purchaser to 21 could gut our key young adult market (17-20)” The Institute of Medicine agreed in a 2015 report predicting that were the minimum age for the sale of tobacco products 21, over time, the adult smoking rate would decline by about 12 percent and smoking-related deaths would decline by ten percent. The report also states, “Although changes in the minimum age … will pertain to individuals who are 18 and older, the largest proportionate reduction …. will likely occur among adolescents of ages 15 to 17 years.” Research shows that kids often turn to older friends as sources of cigarettes. Raising the sale age to 21 would reduce the likelihood that a high school student will be able to legally purchase tobacco products for other students and underage friends.
The legal age for the purchase of tobacco products is set by states and in some cases counties. Hawaii became the first state to raise the tobacco sale age to 21 and just last week California joined them. At least 135 localities in nine states have also raised the tobacco age to 21.
The U.S. Federal Drug Administration recently announced a “deeming rule,” which extends its authority to cover all tobacco products. However, the rule does not restrict online e-cigarette sales and marketing, including flavors such as “cotton candy” and “gummy bears” designed to entice youth.
As Texans, we want to protect our children and make sure they grow up healthy and safe. Raising the legal age to buy tobacco products to 21 years is a proven strategy to do this. Let’s make it a priority to protect our families and communities — while saving money — by starting this discussion.
Note: Catherine Troisi is an epidemiologist at the UT Health School of Public Health in Houston.