Research & Commentary: Arizona Lawmakers Should Not Move Smoking Age to 21

Published February 26, 2018

Lawmakers in Arizona are considering increasing the age to purchase tobacco products from 18 to 21 years old. The proposal would also include a civil fine for persons under 21 who are found possessing tobacco products. Similar legislation failed in 2017.

Proponents say the change will help deter youth from smoking, but these proposals extend to other tobacco and nicotine products, including e-cigarettes and smokeless tobacco, thereby discounting the public health benefits provided by such products. Increasing the tobacco age would limit adults’ choices and negatively impact the state through lost revenue by creating an incentive for adults to purchase tobacco, e-cigarettes, and vaping devices in neighboring states or online.

In every state, individuals are considered adults at 18. They can serve in war; are tried as adults in courts; can accumulate massive debt in contractual agreements, such as student loans; and 18-year-old males are required by the federal government to sign up for the draft. If these individuals can accommodate these “adult” privileges, why would the government disallow them the choice to use tobacco products or products that might help them quit smoking cigarettes?

Evidence used to defend proposals that would increase age limits is circumstantial, at best. According to the National Institute on Drug Abuse, 58 percent of high school seniors reported using alcohol in 2015, and 35 percent reported using marijuana. Both of these are illegal to persons 21 years and younger, yet age restrictions did not halt consumption.

Further, 90 percent of tobacco users started smoking before age 18, according to the Centers for Disease Control and Prevention. Those under 18 also rely on “social sources” for tobacco products, including siblings, friends, parents and strangers; age restrictions will fail to address this problem as well. The U.S. Drug and Food Administration found “86% of 15 to 17 year olds obtained cigarettes” through these social sources.

Perhaps the most troubling issue with the proposal in Arizona is the inclusion of tobacco harm reduction (THR) products, including smokeless tobacco, e-cigarettes and vaping devices. Growing research continues to indicate that these products have proven to be a safer alternative to combustible tobacco smoker and have helped thousands quit smoking.

Smokeless tobacco products, such as snus, deliver nicotine in a safer manner compared to combustible cigarettes. In 2009, BioMed Central analyzed “the relative risk of cancer among smokeless tobacco users, compared with non-users of tobacco.” The authors found “very little risk” of smokeless tobacco producing elevated risks. Dr. Brad Rodu, a senior fellow at The Heartland Institute has over 20 years of research on the health effects of smokeless tobacco. Analyzing data from Sweden, Rodu found “Swedish men have the highest rate of smokeless tobacco use in Europe, which is directly linked to the lowest smoking rate on the continent. Swedish men also have the lowest rates of lung cancer and other smoking-related diseases in Europe.”

Other THR products include e-cigarettes and vaping devices, which have helped thousands of people quit smoking combustible cigarettes. Public health organizations around the world have noted these products are significantly safer than combustible tobacco cigarettes.  In 2017, NHS Health Scotland declared vaping “less harmful than smoking.” In 2016, the Tobacco Advisory Group of the Royal College of Physicians in the United Kingdom concluded the health risks of THR products are “unlikely to exceed 5% of the harm [caused by] smoking tobacco.” In 2015, Public Health England asserted e-cigarette us as roughly “95% safer than smoking.”

Other research indicates the use of THR products could also help aid states’ budgets. Research by J. Scott Moody, chief executive officer and chief economist at State Budget Solutions, concluded Medicaid could have saved an estimated $48 billion in 2012 if e-cigarettes had replaced combustible cigarettes used by current Medicaid recipients who consume tobacco products.

Lawmakers in the Grand Canyon State should not limit adults’ choices by increasing the age to purchase and possess tobacco products. Rather, policymakers should implore the use of THR products such as smokeless tobacco and electronic cigarettes, as these have proven to be effective tools for combustible cigarette cessation.

 

The following articles provide further information on tobacco harm reduction.

Vaping, E-Cigarettes, and Public Policy Toward Alternatives to Smoking
https://heartland.org/publications-resources/publications/vaping-e-cigarettes-and-public-policy-toward-alternatives-to-smoking
For decades, lawmakers and regulators have used taxes, bans, and burdensome regulations as part of their attempt to reduce the negative health effects of smoking. Recently, some have sought to extend those policies to electronic cigarettes. This booklet from The Heartland Institute urges policymakers to re-think that tax-and-regulate strategy. Policymakers should be mindful of the extensive research that supports tobacco harm reduction and understand bans, excessive regulations, and high taxes on e-cigarettes often encourage smokers to continue using more-harmful traditional cigarette products.

Research & Commentary: Cities and Sates Consider Increasing Tobacco Age Limit to 21, Regulating ENDS as Tobacco Products
https://heartland.org/publications-resources/publications/research–commentary-cities-and-states-consider-increasing-tobacco-age-limit-to-21-regulating-ends-like-tobacco-products
In this Research & Commentary, Heartland Institute State Government Relations Manager Lindsey Stroud examines the states and municipalities that are considering increasing their smoking age from 18 to 21. Stroud says such laws fail to substantially curb consumption, and she argues the inclusion of tobacco harm reduction tools, such as e-cigarettes and vaping devices, would negatively impact the health gains these products have been repeatedly shown to provide.

Research & Commentary: Study Finds E-Cigarettes Would Prevent 6.6 Million Premature Deaths
https://heartland.org/publications-resources/publications/research–commentary-study-finds-e-cigarettes-would-prevent-66-million-premature-deaths
In this Research & Commentary, Heartland Institute State Government Relations Manager Lindsey Stroud examines an October 2017 Tobacco Control study that found electronic nicotine delivery systems (ENDS) might help extend life for millions of people. The authors of the study found there was an estimated 6.6 million fewer deaths and more than 86 million fewer-life-years lost over a ten year period because of ENDS products. Stroud concludes the use of ENDS could also help improve the budgets of numerous state programs, including Medicaid.

Research & Commentary: Public Health Officials Urge Use of Electronic Nicotine Delivery Systems
https://heartland.org/publications-resources/publications/public-health-officials-urge-use-of-electronic-nicotine-delivery-systems
In this Research & Commentary, Heartland Institute State Government Relations Manager Lindsey Stroud notes the importance of NHS Health Scotland’s joint statement encouraging the use of electronic nicotine delivery systems (ENDS) as an alternative to tobacco products. NHS Health Scotland, Public Health England, and other groups have found ENDS are 95 percent less harmful than tobacco cigarettes.

Research & Commentary: Qualitative Study on E-cigarettes Shows More Evidence of Tobacco Harm Reduction
https://heartland.org/publications-resources/publications/qualitative-study-on-e-cigarettes-shows-more-evidence-of-tobacco-harm-reduction?source=policybot
In this Research & Commentary, Heartland Institute State Government Relations Manger Lindsey Stroud examines a study, published in The International Journal of Environmental Research and Public Health in June 2016, that provides additional evidence showing e-cigarettes and vaporized nicotine products (VNPs) are an effective tobacco harm-reduction tool.

E-Cigarette Primer for State and Local Lawmakers
http://heartland.org/policy-documents/e-cigarette-primer-state-and-local-lawmakers
Joel Nitzkin provides evidence e-cigarettes work as a tobacco harm reduction modality and reviews the arguments against them. He closes with recommendations for actions state and local lawmakers should and should not consider regarding tobacco harm reduction and e-cigarettes. 

Nothing in this Research & Commentary is intended to influence the passage of legislation, and it does not necessarily represent the views of The Heartland Institute. For further information on this and other topics, visit the Budget & Tax News website, The Heartland Institute’s website, our Consumer Freedom Lounge, and PolicyBot, Heartland’s free online research database.

The Heartland Institute can send an expert to your state to testify or brief your caucus, host an event in your state, or send you further information on a topic. Please don’t hesitate to contact us if we can be of assistance! If you have any questions or comments, contact John Nothdurft, Heartland’s government relations director, at [email protected] or 312/377-4000.