Tobacco use is still the No. 1 preventable cause of death in the U.S., yet over 37 million adults still smoke. Nearly half of them live with a smoking-related disease that eventually will lead to debilitating illnesses and premature death. In Texas, 10,400 kids become daily smokers every year. They become addicted at an early age, with about 95 percent of adults who currently smoke having started before they turned 21. One-third of them will die prematurely. We can and must reverse these trends. It is time for Texas to raise the tobacco sale age from 18 to 21.
The cost of doing nothing is clear. Each year, Texans pay more than $8.85 billion in smoking-caused health bills. Without additional action to reduce tobacco use, nearly half a million young people in our state will die early from a tobacco-related disease.
The power of tobacco that keeps people smoking is the highly addictive chemical nicotine. Nicotine has particular effects on a developing brain, which is why it is so harmful to children and younger adults. Exposure at a young age leads to a high likelihood of lifelong addiction.
Raising the tobacco sale age is an important strategy to reduce the number of tobacco-addicted adults. In a comprehensive report published in 2015, the prestigious National Academy of Medicine (then known as the Institute of Medicine) concluded that increasing the national tobacco age “will likely prevent or delay initiation of tobacco use by adolescents and young adults” and will likely lead to a “substantial reduction in smoking prevalence.”
That same report predicted that raising the tobacco sale age to 21 will mean that those who legally obtain tobacco “are less likely to be in the same social networks as high school students,” creating a much-needed gulf between tobacco and high schools.
Legislation to raise the tobacco sale age in Texas should also apply to electronic cigarettes, which, like regular cigarettes, can contain nicotine. In December, the National Institute for Drug Abuse reported that 1.3 million more high school students use e-cigarettes now than in 2017, a 78 percent increase — the largest for any substance use in the survey’s 43-year history. The new findings prompted the Surgeon General to issue an advisory declaring e-cigarette use among youth “an epidemic” and calling on parents, teachers, health professionals and local authorities to take action to discourage their use by young people.
Of course, passing any law or ordinance is meaningless without enforcement. Successful measures to curb tobacco sales for those under 21 have relied on enforcement upheld through compliance checks, signage, retailer education and holding retailers accountable through fines for violating the law. Prohibiting sales to individuals under 21 will help deliver compounding results over time, beginning with reductions in smoking initiation and prevalence.
The movement to raise the tobacco sales age is gaining momentum nationwide. Six states have already done it, along with more than 430 cities and counties across the country — including San Antonio, where an ordinance went into effect on October 1.
Now it is time for Texas to step up and pass a statewide law raising the tobacco sale age to 21. Past efforts to raise the age have enjoyed broad bipartisan support at the Capitol, and polls show that Texans strongly favor it.
It is simply unacceptable for our great state to continue losing lives and money to a preventable problem. We urge Democrats and Republicans to work together in this legislative session to raise the tobacco age in Texas — for the future of our children and our state.
The authors are members of the Texas Tobacco 21 Coalition.
Disclosure: The Texas Medical Association has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.