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Op-ed: This doctor says raise the tobacco age and save lives

By Kevin Nelson

First Published Feb 20 2014 04:40 pm • Last Updated Feb 20 2014 04:42 pm

It can be a difficult conversation with a teenager: Why smoking is bad for your health and how it leads to longer-term, chronic health problems.

Sure, this seems like simple knowledge kids should easily absorb from parents and teachers. But in my role as a pediatrician, community outreach educator at schools and advocate for the Utah Tobacco Prevention Task Force, I still encounter kids who choose to light up despite living in an age where the health risks of tobacco are well-documented and emphasized in the media, at school and at home in many cases.

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Several of the young patients I see who have become addicted to smoking during their teenage years started using tobacco to fit in. Peers gave them their first cigarette and before long tobacco became a regular part of their lives. As a pediatrician, I often wonder what would happen in our state if teenagers couldn’t legally buy cigarettes? Would more be spared a life-long addiction? Would we see fewer patients suffering from tobacco-related illnesses?

Statistics elsewhere — as well as admissions from tobacco company executives themselves — show this is exactly what might happen. It’s why I’m hopeful the Utah State Legislature will pass Senate Bill 12, by Sen. Stuart Reid, R-Ogden, this session. Reid’s bill would make 21 the legal age for purchasing tobacco products in Utah. There are several reasons for why such a move would have considerable health benefits.

Recent data from the U.S. Department of Health and Human Services shows that 95 percent of adult smokers begin smoking before they turn 21, and a substantial number of smokers start even younger — more than 80 percent of adult smokers first try smoking before age 18. This means the 18-to-21 age range is a time when many smokers transition to regular use of cigarettes.

In Utah, the average age of smoking initiation among Utah youth is 13.1 years old, according to a 2013 survey by the Utah Department of Health. More than 60 percent of those who tried cigarettes reported receiving them from friends. A fact many of those young smokers don’t realize while experimenting is that 80 percent of kids who start smoking in high school continue to smoke into adulthood.

Delaying the age that youth can legally use tobacco will reduce the risk that they will become regular smokers as they get older. Estimates indicate that raising the legal age would not only curb smoking prevalence among youth, but the rates for adults would also slowly decline over time. That predicted decrease in the number of tobacco users in Utah could save much of the $830 million that the state of Utah spends each year on tobacco-related health care costs and lost productivity, according to the Centers for Disease Control.

Tobacco giant Phillip Morris raised concerns in 1986 about cigarette sales in states where selling tobacco to teenagers was restricted, "Raising the legal minimum age for cigarette purchaser to 21 could gut our key young adult market (17-20) where we sell about 25 billion cigarettes and enjoy a 70 percent market share."

Tobacco companies like Phillip Morris’ fears revolved around sales, but our fears should stem from the negative health impact our state might encounter if the legal limit for tobacco stays at 19. The FDA is prohibited by the Tobacco Control Act from raising the tobacco purchase above 18 years of age. Overwhelmingly, 67 percent of Utahns support raising the purchase age to 21. Don’t we owe it to our young people to implement policies that foster positive health outcomes? It is time for a healthier Utah.

Kevin Nelson is a pediatrician and an instructor at the University of Utah School of Medicine. He founded the Utah Tobacco Prevention Task Force, facilitates the Utah Medical Association Straight Talk Program on tobacco and drug use and has served as chair of the Coalition for a Tobacco Free Utah.

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