The health costs of tobacco use dwarf the impact of opioids. Opioids kill about 42,000 Americans annually. Tobacco kills almost 500,000.
In the upcoming legislative session, Washington state lawmakers again have an opportunity to be public health heroes. By raising the legal age to buy tobacco products to 21 from 18, we can save lives and money in our state.
If you feel like Bill Murray in Groundhog Day, you aren’t alone. We had the same opportunity last legislative session and the two previous ones. In the past, the Tobacco 21 law died in the Republican-controlled Senate before coming to a vote, but with the Senate’s recent leadership change, the Tobacco 21 law has been given new life.
A major reason the regulation has failed in the past is because it will work. It would decrease tax revenue from cigarette sales over the next two-year budget cycle by $15 million. Now that five other states and hundreds of cities and counties already have enacted this change, we can be even more confident that it would decrease rates of tobacco use in youth and adults.
As an example, when Needham, Massachusetts, raised the legal age to purchase tobacco, it experienced a 47 percent reduction in high-school smokers. The Tobacco 21 legislation is an investment in our children, and in exchange for our investment, Washington will save lives and reduce health-care costs.
Opioid use disorders have gotten well-deserved attention in both the executive and legislative branches of Washington state government. I work in Clallam County, the county with the highest rate of opioid-associated death in the state, and I spend a large portion of my time working on public-health approaches to managing the opioid crisis. But the burden of tobacco use dwarfs the impact of opioids. Opioids kill about 42,000 Americans annually. Tobacco kills almost 500,000.
Tobacco, like opioids, disproportionally impacts 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 and opioids are both sad examples. On the Olympic Peninsula, our teens and pregnant women smoke at almost double the state average, leading to higher rates of infant mortality, pregnancy complications and lung cancer.
The opioid crisis is complicated and requires a wide range of interventions across our medical, mental-health, treatment and law-enforcement systems. I wish we had something as easy as the Tobacco 21 legislation to address the opioid crisis. Having a straightforward intervention with a proven track record should make this an easy decision. Every year that we wait to make this change creates another cohort of young people who will suffer the negative health impacts of smoking and create unnecessary costs for our publicly funded health-insurance system.
Raising the legal age to purchase tobacco products now has bipartisan support in the Legislature, among the public, in the military and even among current smokers. Tobacco kills and maims more people than alcohol, marijuana, opioids and suicide combined. By heeding and acting on the best evidence, we can save the lives of thousands of Washingtonians and create consistency in our age restrictions for alcohol, marijuana and tobacco products.