The Public Health Benefits of Raising the Age for Buying Tobacco Products to 21

Advocates say the new provision will save lives—but some question whether it goes far enough

Tobacco 21
Starting in the summer of 2020, it will be illegal in the United States to purchase tobacco products, including e-cigarettes and vaping devices, under the age of 21. Stephanie Keith via Getty Images

As part of a congressional spending bill that President Trump signed into law on Friday, the federal legal age for purchasing tobacco products has been raised from 18 to 21. This measure, according to the American Lung Association, has the potential to “significantly reduce youth tobacco use and save thousands of lives.”

As Jamie Ducharme reports for Time, the new provision applies to both “traditional” tobacco products, like cigarettes and cigars, and to e-cigarettes, which contain nicotine derived from tobacco. American teenagers have been using such devices in “record numbers,” according to the National Institutes of Health—a point of grave concern as a wave of severe vaping-related illnesses have affected more than 2,500 people across the country.

The new legislation will take effect in the summer of 2020. Before the passage of the federal law, at least 19 states and the District of Columbia had “some form” of provisions setting the age for tobacco purchases at 21, reports Merrit Kennedy of NPR.

Advocates say that “Tobacco 21” laws can make an impact in several ways. Ninety percent of daily smokers reported first using cigarettes before the age of 19, according to a 2015 report by the Institute of Medicine of the National Academies. Smokers aged 18 and 19 often supply younger friends and classmates with tobacco products, but “[s]ince students do not typically reach 21 years old while still in high school, increasing the age of sale would greatly reduce the number of high school students who could purchase tobacco products,” according to the American Lung Association. The new age limit will also counter tobacco industry marketing campaigns that influence teenagers and young adults, the organization says.

Raising the age limit for tobacco purchases, the 2015 report concluded, will “likely prevent or delay initiation of tobacco use by adolescents and young adults,” particularly among those aged 15 to 17.

The push to curb teenage tobacco use has become particularly urgent amid a growing public health crisis. Earlier this year, health officials expressed concern about the rise in an “e-cigarette, or vaping, product use associated lung injury,” also known as EVALI. The CDC says that 2,506 people have been hospitalized with the condition to date, 78 percent of whom were under the age of 35 . Fifty-four people have died from severe lung injuries, according to Sheila Kaplan of the New York Times.

Most of the affected patients reported using products containing THC, the main psychoactive compound in marijuana. Just last week, a survey funded by the National Institute on Drug Abuse showed sharp increases in marijuana vaping among teenagers; 14 percent of 12th graders, for instance, said they had vaped marijuana over the past month, nearly double the percentage reported last year. But THC products do not seem to be the sole culprit of the recent injuries. Thirteen percent of patients “reported exclusive use of nicotine-containing products,” according to the CDC. The new survey found that 11.7 percent of 12th graders said they vaped nicotine daily this year.

Recent research has shown that the use of e-cigarettes can also double a person’s risk of developing chronic lung conditions like asthma and emphysema, compared to individuals who have never smoked.

Major tobacco companies, including the e-cigarette giant Juul, have expressed support for efforts to raise the minimum age for tobacco purchase, according to NPR’s Kennedy. But some advocates say that companies are simply willing to accept this restriction in place of other strategies for curbing teen smoking—like banning e-cigarette flavors, which are “very popular among youth and adults,” according to a recent study.

“Any serious solution to skyrocketing rates of youth e-cigarette use must include the removal of kid-friendly flavors, not just the tobacco industry’s preferred policy,” Dick Durbin, a Democratic Senator of Illinois, said in a statement.

“Raising the tobacco age to 21 would be a positive step, but it is not a substitute for prohibiting the flavored products that are luring and addicting our kids,” said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids. “The other tobacco provisions in this agreement also will not bring about meaningful change, but will lead to the tobacco companies falsely claiming that the youth e-cigarette problem has been solved even as it continues to grow worse every day.”

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