On January 1, Hawaii became the first state in the nation to raise its smoking age for traditional and e-cigarettes to 21, earning appreciative nods from public health officials who hope move will deter teenagers from picking up smoking in the first place.
Justin Warren, an Army X-ray technician, is among residents who disagree with the new law. "If you can serve the country, you should be able to have a drink and a cigarette," he told the Associated Press. It's a particularly evocative argument in Hawaii, which has a high concentration of military personnel. On the whole though, the public temperature was positive.
"We see it as a fitness and readiness issue," Bill Doughty, a spokesman for the Navy Region Hawaii told the AP. "When we can prevent sailors from smoking or using tobacco, if we can get them to quit, then that improves their fitness and readiness, and it saves them a ton of money too."
Kathryn Braun, a professor of public health and director of the University of Hawaii's Office of Public Health Studies, pointed out that 95 percent of adult smokers began smoking before the age of 21. "Restricting sales to individuals 21 and older could limit the number of young people who start smoking in their teens and are addicted by age 21," she told The Huffington Post.
Hawaii's new law come on the heels of a report issued last March by the Institute of Medicine that projected raising the minimum age to buy cigarettes nationwide would translate to 249,000 fewer premature deaths, 45,000 fewer deaths from lung cancer, and 4.2 million fewer years of lost life from smoking for individuals born between 2000 and 2019.
This is especially important because according to a study published in December in the Journal of Adolescent Health, there's evidence that teenage brains respond more strongly to cigarette exposure than adult brains, making young people particularly vulnerable to developing an addiction.
Public health officials are also concerned with the spike in e-cigarette use among high school students. The number of young e-cig users rose from 660,000 to 2 million between 2013 and 2014, according to the National Youth Tobacco Survey.
Tobacco use takes a huge toll on public health, regardless of age. According to the American Cancer Society, cigarette smoking accounts for 30 percent of all cancer deaths, killing more Americans than alcohol, car accidents, suicide, homicide, AIDS and illegal drugs combined.
But again, most of those smokers started their habit early: Nearly 90 percent smoked their first cigarettes by age 18 and nearly 99 percent were smoking by 26, according to the Centers for Disease Control and Prevention.
Widening the gap between smokers and teens
Since adolescents are already smoking illegally, some have argued that raising the smoking age is pointless, a viewpoint that Institute of Medicine report strongly rebuts. Its authors hold that widening the age gap between adolescents and legal smokers makes it less likely that 15- to 17-year-olds will have legal tobacco users in their social circle, one of the primary contributing factors to early adolescent tobacco use.
As for the if-you're-old-enough-to-serve-your-country argument, Braun said the same logic was used to protest raising the drinking age from 18 to 21, "but this is now the norm," she said.
And while restricting sale and possession of tobacco to people 21 and older is a good start, there's still work to do. "Teens are very susceptible to marketing targeted to them by tobacco companies," Braun said. "More needs to be done to keep youth from starting the habit."
To that end, Hawaii isn't alone: Four other states have bumped their minimum tobacco access age up to 19 and Needham, Massachusetts, a suburb of Boston, was the first city to raise the smoking age to 21 in 2005. Since, then more than 100 cities and counties followed suit.
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