In a divided Congress where many legislators are looking to make bipartisan inroads, lawmakers should note two numbers of significance: 9 percent and 36 percent. One number demonstrates the success we have achieved when considering the greater health of our country; the other represents a growing threat.
In 2018, smoking among 8th, 10th and 12th graders fell to its second lowest level in the 41 years since the well-respected Monitoring the Future Study (MTF) has been conducted. With only 4.6 percent of teens having smoked in the last 30 days, it represents a success story on this key addiction front that has come a long way since a record 39 percent of all teens smoked in 1976.
Despite this progress, the Food and Drug Administration (FDA) reports that teen and youth tobacco usage increased from 3.6 million in 2017 to 4.7 million in 2018, a 30 percent increase in one year.
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The National Youth Tobacco Survey (NYTS) identifies the rapid replacement for cigarettes — e-vapor products (e-vapor). With growing alarm, e-vapor now accounts for 20.8 percent of all tobacco usage at the high school level.
Any celebration of success of a reduction in youth smoking cigarettes ignores the gripping e-vapor reality that has been described by FDA Commissioner Scott Gottlieb as an “epidemic.”
Studies dating back to 1929 pointed to the harmful effects of cigarettes and led to the nationwide push for states to adopt a minimum legal age (MLA) for tobacco purchase. Today, there is irrefutable evidence that smoking is the leading cause of preventable disease and death in the United States, with adolescence serving as the most common stage for initial usage. What we also know is the deleterious health impacts of highly-addictive nicotine, particular for adolescents. According to Dr. Darcy L. Lesniak, a pediatrician at Ascension Columbia St. Mary’s Ozaukee in Wisconsin, “Nicotine is an addictive substance that has harmful effects on a developing adolescent brain. Because their brains are still developing, teens are more susceptible to addictions than adults.”
Fight addiction by education, restricting access
We have learned over time that there are two key components to any successful tobacco cessation effort: restricting access and education. The shocking rise in e-vapor usage has provided the necessary siren call to public health officials, and I am optimistic that FDA will continue to educate and raise awareness about the negative health impacts of e-vapor products for youth, while strengthening enforcement to prevent illegal sales to underage children. Unfortunately, those efforts alone will not be enough.
If we truly want to curb the use of e-vapor among adolescents, we must heed the lessons of history and curb access. No other means of restriction provides as direct an ability to reduce underage access as raising the federal minimum age to purchase tobacco to 21, which is also currently under legislative consideration in Maryland, Texas, and a number of other states. Seven states, including California, Virginia and Massachusetts, have already raised the MLA to 21. Raising the MLA to 21 is also supported by numerous public health organizations.
Why a 21 federal MLA? The vast majority of students turn 18, the current MLA, before exiting high school — allowing underage students an easy access point for e-vapor and other tobacco products through friends. Raising the federal MLA to 21 would vastly reduce social access to underage children, as no high school student would be able purchase tobacco products.
A bipartisan public health intervention
If we have the opportunity to bend the curve of e-vapor usage beginning today among our adolescents, doesn’t that outweigh any real or perceived lesser harms? The reality is that education alone will not reverse the rising underage e-vapor usage rates and a more direct action is necessary for the good of public health.
To be clear, I do not support government intervention regarding age access to e-vapor products beyond 21 as I firmly believe in personal decision-making and whatever consequences it may bring. However, a national effort restricting the age of purchasing tobacco products would go a long way toward driving down tobacco usage among teens.
This is an initiative that, in a time of bitter divisions in Washington, both Republicans and Democrats can get behind. Together, we can draw a line refusing to accept such unbridled growth in teen tobacco usage, and it begins with a unified and strong limitation on the minimum legal age to purchase tobacco products. Now is the time for Congress to act and raise the federal MLA to 21.
Tommy G. Thompson , Wisconsin governor from 1987 to 2001, was Health and Human Services secretary in the George W. Bush administration. Follow him on Twitter: @TommyForHealth
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This article originally appeared on USA TODAY: Raise the federal minimum legal age for tobacco, e-cigarette purchases to 21