Tobacco age-limit increse discussion

1. Tobacco 21
The case for raising the legal age to sell
cigarettes to age 21
Timothy A. Sanborn MD
Division of Cardiology
NorthShore University HealthSystem
Clinical Professor of Medicine
University of Chicago
Pritzker School of Medicine

2. This year represents the 50th anniversary of the landmark
1964 surgeon general’s report on Smoking and Health

3. Through public education, smoking cessation programs and
health policy efforts of smoke free laws and tobacco taxes,
smoking rates in the United States decreased from 43 % in
1964 to 18 % in 2012
Cole, JAMA 2014: 311 1131-2

4. Smoking remains the No. 1 preventable cause
of death in the U.S.
Smoking kills nearly half a million Americans
and costs the nation $193 billion in healthcare
expenses and lost productivity each year.
However,
American Heart Association

5. Tobacco 21- An Idea Whose Time Has Come
 Needham, MA was the first town to adopt Tobacco 21 and raise
the age to purchase cigarettes to age 21 in 2005
 The decline in high school students smoking in Needham was
triple that of its neighboring towns. Thus, the hypothesis that
young people would shift their purchases to nearby towns was
proven false.
 In 2013, seven Massachusetts towns and one Hawaiian county
adopted Tobacco 21 laws.
 Similar legislation has been introduced in a growing number of
communities and at least three states: New Jersey, New York
and Utah.
 Further dissemination of Tobacco 21 laws represent a critical
opportunity for public health law to reduce one of the most
important health risks facing the U. S. Population.
Winickoff, NEJM 2014; 370: 295-7

6. Tobacco 21- An Idea Whose Time Has Come
 31% of smokers progress to daily smoking in early
childhood.
 Neuroscientific evidence indicates that the adolescent
brain has a heightened susceptibility to addictive qualities
of nicotine-more of a reason to suggest Tobacco 21 to
other towns/cities.
 According to a recent Gallup poll, 90% of adults who
smoke claim if they had a chance to do things over again
they would have never started smoking in the first place!
Winickoff, NEJM 2014; 370: 295-7

7. 12.9% 14.9% 6.7% 12.4%
0.00%
2.00%
4.00%
6.00%
8.00%
10.00%
12.00%
14.00%
16.00%
Needham, MA Surrounding
Communities
Needham, MA Surrounding
Communities
%ofsmokinghighschoolstudents
Before 2005
The Outcome of Implementing
Tobacco 21
2010

8. 44%
35%
14%
8%
46%
30%
8%
4%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Alcohol Marijuana Cigarette Rx
2011
2012
Comparing Past 30 Day Use (ETHS)
2012 IYS from
ETHS

9. Comparing Past 30 Day Cigarette Use
(ETHS)
5%
15% 16%
21%
4% 5%
11%
15%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
9th 10th 11th 12th
2011
2012
2012 IYS from
ETHS

10. Tobacco Access Among Tobacco
Users (Past Year - ETHS)
52%
44%
5%
30%
1%
85%
15%
5%
18%
6%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Bought at a
gas station
Bought at a
store
Bouth from a
vending
machine
Gave a
stranger
money
Bought over
the Internet
From a friend From an older
sibling
From a parent
(knowingly)
From a parent
(unknowingly)
Took from a
store

11. Tobacco 21
 The Evanston Health Advisory Council (EHAC)
recently voted 9-0 to strongly recommend
Tobacco 21 laws so that Evanston can be the
“health leader” in Illinois.