Raise the age to 21 to purchase tobacco?
A proposal currently before the Unified Government Commission would make it illegal to sell tobacco to anyone under 21 in Kansas City, Kan.
Currently, anyone 18 and older can buy tobacco here, according to UG officials.
The plan, as presented Monday night to the UG Administration and Human Services Standing Committee, would be to raise the age to 21 in order to stop the flow of tobacco products to those who are younger than 18.
The Greater Kansas City Chamber, with support from doctors at the University of Kansas Medical Center and Medical School, are backing the change.
Exact proposal is limited to purchase of tobacco only
Commissioner Ann Murguia said the goal of this group effort was to change the age in which people can purchase tobacco from 18 to 21. They’re not asking for a law to prohibit those from 18 to 21 from smoking, nor are they asking for a fine on someone who buys cigarettes for those who are 18 to 21, she added.
“It is simply one small incremental step to make those youths between 18 and 21 think twice before making a decision to become a smoker,” Commissioner Murguia said.
Arguments in favor of raising the age to 21
Scott Hall, vice president for strategic initiatives at the Greater Kansas City Chamber of Commerce, said health is an economic driver. Tobacco 21 KC is one part of the Healthy KC program the chamber has been working on for a few years, he said. Hall said the cost savings to businesses from fewer smokers are real and are becoming increasingly important to the bottom line of the business community.
“Tobacco is a primary risk factor for cardiovascular disease and death, and by changing the laws from 18 to 21 to purchase tobacco, it would have very many important impacts on both the health of Kansans as well as our patients,” said Dr. Robert Simari, executive dean of the KU School of Medicine and a cardiologist.
Most people who smoke start in their young teens, he said.
Smoking exposure generally comes from one’s community of students and friends, he said. Since many students are still in high school when they are 18 years old, that could result in 18-year-olds bringing tobacco into the schoolyard around younger students and to groups of friends, he said.
The adolescent brain is greatly much more easily addicted to nicotine than more mature older brains, he said. Getting cigarettes in the hands of young people not only causes them to be addicted but to have a lifetime of addiction to smoking, Dr. Simari said.
The Institute of Medicine has studied the issue and suggested that a smoking age of 21 would have an ideal impact in reducing smoking in a community, he said.
He said it was important for the KU Cancer Center to demonstrate that it can move the needle on reducing cancer in Kansas, and this is one of the public-private partnership efforts that could do so.
Dr. Edward Ellerbeck, chair of preventive medicine and public health at KU, said he has seen many patients who are victims of nicotine addiction.
Teens’ brains do not fully develop until their early 20s, he said. While cancer and heart disease are related to the other ingredients in tobacco, it is the nicotine that causes addiction and affects the development of the brain, Dr. Ellerbeck said.
Whether it comes from e-cigarettes or regular cigarettes, it isan addictive substance that changes the way the brain works, he said.
“We have an epidemic of e-cigarette use in our schools, so when we’re talking about Tobacco 21, we’re really talking about Nicotine 21 and raising the access to 21 for all nicotine products,” Dr. Ellerbeck said.
Younger brains are more sensitive to the addictiveness of cigarettes, so that if someone starts smoking at age 14, they’re twice as likely to become a lifetime smoker than if they wait until age 21, he said.
And nicotine also sensitizes the brain to other addictive substances, he added.
Even though they’re talking about ages 18 to 20, these youth are in social networks with high school and middle school students, he said. The biggest effect of this legislation would be to age 14 to 17 years old, he said.
“For every thousand kids who come through our schools, about 200 of them are going to end up being a lifetime smoker,” Dr. Ellerbeck said. “If there’s a 25 percent reduction, that’s 50 less smokers coming out of our schools from a Tobacco 21 initiative. Currently one in three smokers will die as a result of the disease, so that’s 17 lives saved for every 1,000 people in our schools.
“That’s the kind of impact I actually can’t have in my clinic, but the county commission actually has that potential power,” he said.
Rebecca Garza, the Tobacco Free Wyandotte coordinator of the Healthy Communities Division, Wyandotte County Health Department, said the sale and purchase of tobacco products, including alternative nicotine delivery devices, would be limited to those 21.
She said Needham, Mass., was the first community to pass Tobacco 21 in 2005. In the first five years, teen smoking went down 46 percent, according to Garza. In 16 surrounding communities there was a 20 percent decrease in teen smoking.
The Institute of Medicine estimates that Tobacco 21 would reduce smoking among 15 to 17-year-olds by 25 percent and among 18 to 20-year-olds by 15 percent, she said.
Garza said it would help keep tobacco out of high schools, because 18-year-old seniors now can purchase tobacco for their younger friends.
She said in Needham, no convenience stores went out of business, and business dropped only 2 percent. But there was a huge effect in reducing costs to private employers, she said.
The cost annually of a smoker working at a business was about $5,816, she said, including costs due to absenteeism, breaks, and health care costs.
Currently 94 cities in nine states have enacted Tobacco 21 policies, covering more than 13 million people, she said. She said 75 percent of adults who were surveyed favored raising the purchase age for tobacco to 21.
Besides KU Medical Center, organizations that have endorsed raising this age to 21 include Providence Medical Center, Children’s Mercy Hospital, Kansas Public Health, Community Health Council of Wyandotte County, Healthy Communities Wyandotte, El Centro, Latino Health for All Coalition, Greater Kansas City Health Care Foundation, YMCA, Women’s Chamber of Commerce of KCK, and other groups.
Commission discussion: ‘Here to govern, not to dictate’
While most commissioners seemed to support moving this proposal forward to the full UG Commission for further discussion, one commissioner had a different opinion.
Although he’s not a smoker, Commissioner Mike Kane pointed out that a lot of smokers had served in the armed forces. Some have later quit.
“We’re here to govern, not to dictate,” Commissioner Kane said. However, he was the only commissioner at the committee meeting who expressed opposition to the proposal.
However, Commissioner Jane Philbrook said smokers were a big loss to employers in time and attention to jobs because no one else takes those kinds of breaks. She said her dad died of emphysema because he started smoking at 13 years old. Smokers will tell you that because they started so young, it is hard to kick the habit, she added. She favored the change to 21 years old.
In answer to a question from Commissioner Gayle Townsend, the UG legal staff stated that the UG could make the tobacco ordinance more restrictive than it is now, raising the age to 21. But it could not make it less restrictive, lowering it under 18, as that would conflict with state law.
Issue could go to full UG Commission meeting
There was a consensus, but not a vote, that Commissioner Murguia would ask the mayor to place this issue on the full UG Commission agenda for a presentation, discussion and a vote.