Column: Raise the tobacco sales age to 21

Many people are surprised to learn that tobacco use remains the leading cause of preventable illness and premature death in Massachusetts and across the country, despite the strides we have made in reducing cigarette smoking over the past few decades.

Treating tobacco-caused illnesses adds up to $4 billion in annual healthcare costs in Massachusetts. This burden falls on all of us, not just those who use tobacco. An additional $2.5 billion in economic productivity is also lost each year.

Ninety-five percent of tobacco users become addicted to nicotine before age 21. In fact, if you can stop a teenager from starting to use tobacco then it is very unlikely that she will start smoking as a young adult (or later in life). Fewer youth smokers today results in fewer adult smokers tomorrow.

Education and prevention efforts targeted at teens are critical to reducing their use of tobacco, as well as alcohol and other drugs. But finding more money to invest in these programs is always difficult given tight municipal and state budgets.

There is another strategy that does not cost any money and has proven to be very effective in reducing youth tobacco use: raising the minimum legal sales age from 18 to 21.

In 2005, the Town of Needham became the first municipality in the entire country to raise the tobacco sales age to 21. Within five years, the community’s smoking rate had plummeted. In the years since, 150 cities and towns in Massachusetts have followed this example, as well as many others around the country. Hawaii and California are the first two states to raise their legal tobacco age to 21 statewide.

Of course, raising the minimum legal sales age to 21 does not stop all teenagers from accessing tobacco products. But it does make it more difficult. This is because it helps to remove tobacco products from high school social networks. Most younger teens get tobacco products from older teens. Making it harder for 18 and 19 year olds to purchase tobacco will cut the supply to 15 and 16 year olds.

There are more than 800,000 tobacco users in the Commonwealth today. According to an analysis by the Institute of Medicine, raising the legal age from 18 to 21 would be expected to reduce the smoking population over time by 12 percent. This would be a tremendous public health success, saving thousands of lives and millions of dollars.

Some opponents of raising the minimum legal sales age make the argument that since 18 year olds can vote and serve in the military they are also old enough to purchase tobacco products if they so wish. But our society does not have a single, universal age of adulthood. You can get a driver’s license at 16, vote or serve on a jury at 18, and consume alcohol or set foot in a casino at 21. Some activities, such as renting a car, may even require you to be older than 21. We make each of these determinations by evaluating the risks and benefits to individuals and society at large.

Now is the time to act statewide. We have a patchwork of cities and towns across the Commonwealth with different legal sales ages for tobacco. This is confusing for retailers and consumers alike.

We urge the Legislature and Gov. Charlie Baker to act. Let’s save lives and dollars by raising the minimum legal sales age for tobacco from 18 to 21.

State Senator Jason Lewis
State Representative Paul McMurtry
Lynn Nicholas, President & CEO, Massachusetts Health & Hospital Association

Originally run in CommonWealth Magazine.