When teens avoid tobacco addiction, they rarely pick up the habit later in life.
THIS special legislative session, Washington state lawmakers have an opportunity to be public health heroes. By raising the legal age to buy tobacco products from 18 to 21 we can save lives and money in Washington state.
This may sound familiar. We had the same opportunity last year before the Tobacco-21 bill died in the Legislature. It died because the state depends on the tax revenue from addicted teens to balance our state budget. There is universal agreement that changing the legal age for tobacco sales in Washington will save lives and reduce health-care costs. If approved, the estimated decrease in tax revenue over the next two years is $16.5 million, but not passing this legislation would be cruel and shortsighted.
Tobacco use disproportionally robs the wallets and health of our poorest and most vulnerable citizens. In public health, we use the term health disparities to describe the preventable differences in health that occur between populations. Tobacco use is a sad example. In Clallam County, on the Olympic Peninsula, where I practice as a physician, our teens and pregnant women smoke at almost double the state average, leading to higher rates of infant mortality, pregnancy complications and lung cancer. Smoking during pregnancy is so common that the smell of cigarettes in the delivery room no longer surprises me.
Not surprisingly, the negative health effects of smoking are unfairly distributed. If you have less than a high school education, are nonwhite, or live in poorer parts of the state, your risk of smoking is dramatically higher. Raising the legal age to buy tobacco products will help narrow this health disparity and improve the chance our poorest citizens live long, healthy lives. We know this approach works. When Needham, Massachusetts, raised the legal age to purchase tobacco, it experienced a 47 percent reduction in high-school smokers. And when teens avoid tobacco addiction, they rarely pick up the habit later in life.
Thankfully, our legislators have something they didn’t have last year — an appropriate source of new revenue. E-cigarettes and vaping products are not taxed like tobacco products in Washington state. Pending legislation would fix this, decreasing the rates of e-cigarette use (a good thing for public health) and generating millions of dollars in revenue to offset the cost of raising the tobacco age. By raising the age to purchase tobacco and taxing e-cigarettes, the state can save the lives of thousands of Washingtonians.
Arguments against Tobacco-21 legislation are unconvincing. Convenience-store owners worry that fewer tobacco sales will lead to less junk food sales. I wish this were true, but the economic effect in other parts of the country that have raised the tobacco age has been tiny.
Another weak argument is that 18 year olds can serve in the military so they should be able to buy tobacco (even though the age to purchase alcohol and marijuana is 21).
Smoking cigarettes impairs athletic performance and leads to expensive health complications (paid for by taxpayers through the Veterans Affairs). When the Department of Defense estimates that 70 percent of 17- to 24 year-olds in the U.S. would not qualify to serve in the military due, in part, to physical “shortcomings,” anything we do to improve the fitness of our young men and women strengthens our military. This is one reason military leaders support Tobacco-21 legislation.
The special session in Olympia is an opportunity to rescue the Tobacco-21 legislation. Raising the legal age to purchase tobacco products has bipartisan support in the Legislature, among the public, in the military and even among current smokers. We have an opportunity to save money, save lives and decrease health disparities.