Cigarettes disgust Susan Eggman.
“I abhor smoking,” the Democratic assemblywoman from Stockton said.
It hasn’t always been that way. Eggman has inhaled her share of smoke, a habit that smoldered for nearly two decades after she picked it up as an 18-year-old serving in the U.S. Army. As repellent as Eggman now finds smoking, a bill that would raise California’s age for buying tobacco to 21 unsettles her.
“If we allow people to go fight for our country at 18, if we allow people to vote at 18, we should allow people to choose for themselves if they want to smoke,” said Eggman, who served four years as a medic. “If I can ask you to die for your country, who am I to ask you not to smoke?”
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No one disputes that tobacco shortens life spans and encourages a host of potentially lethal diseases. The central question Senate Bill 151 poses to lawmakers is not whether tobacco use is desirable but whether Californians the state otherwise treats as adults should have the freedom, if they wish, to purchase and consume a harmful substance.
“I just reflected on my children and their ages and the level of maturity between an 18-year-old and a 21-year-old,” said Sen. Ted Gaines, R-Rocklin, one of four Republicans who voted to advance the bill out of the Senate. “It just seemed to me that an individual can make a more mature decision at age 21 than at age 18.”
Californians must be 21 to purchase alcohol, purchase handguns and gamble at card clubs and many casinos.
The bill, which has cleared the state Senate and awaits action in the Assembly, will also need to win approval from a Legislature whose members accepted about $145,000 in campaign contributions from tobacco companies last election cycle and last year stymied legislation to regulate the burgeoning electronic cigarette industry.
Public health officials hoping to curb tobacco use consistently focus their efforts on dissuading young people, hoping to prevent addiction before it can begin. Studies suggest that younger people become addicted more easily.
“In a long-term sense, for the tobacco industry,you get a much more likely addiction rate if you start them younger,” said Dr. Donald Lyman, who oversaw California’s tobacco control program.
Research details the possible benefits of raising the age. A March 2015 Institute of Medicine study found that around 90 percent of daily smokers started before they were 19. It predicted that pushing the tobacco age to 21 would cause a 12 percent decrease in tobacco use and spur “substantial reductions in smoking-related mortality,” though that decline would take decades to manifest.
Tobacco vendors dispute those findings. California Retailers Association President Bill Dombrowski argued that making cigarettes tougher to obtain would simply drive underage Californians to the black market, which he noted “doesn’t discriminate against minors.”
And given how many young people manage to get drunk before their 21st birthday, industry skeptics argue that raising the tobacco age will just mean another rule to break.
“Teenagers are very astute to obtain products – look at the alcohol,” said Thomas Briant, executive director of the National Association of Tobacco Outlets. “They will find other ways to do it.”
Advocates counter that underage smokers benefit from having older friends or siblings who can legally buy them a pack, and that a 16-year-old is more likely to know an 18-year-old senior than a 21-year-old willing to buy him or her tobacco.
“There’s a lot of 19-, 20-year-olds that are in high school, and they seem to get their cigarettes and they pass them on to younger children,” said Beverly May of the Campaign for Tobacco-Free Kids.
Californians must be 18 to vote, join the military without parental consent, be tried as an adult, purchase tobacco and play the lottery.
Briant also noted that a higher tobacco age would mean less tobacco tax revenue for California. A Senate analysis determined that California would lose $68 million a year in the near-term and eventually more than $100 million a year.
But the analysis also concluded fewer smokers would eventually translate into “significant health care cost savings” from the diminished cost of treating tobacco-related illness. Around one-third of Californians now get care via state-subsidized health insurance.
“If we’re able to drive down the rates of smoking within the Medi-Cal community, hopefully we can put a dent in some of these high-cost diseases,” said California Primary Care Association spokesman Ben Avey.
Raising the tobacco age to 21 has precedent. New York City and Healdsburg are among the cities and counties to approve an age-21 cutoff in recent years, and Hawaii lawmakers have sent Gov. David Ige a bill to do the same.
A spokesman for Altria, whose subsidiaries include Philip Morris USA, said in an email that states and cities should “allow FDA and Congress the opportunity to think through this issue further before enacting different minimum age laws.”
Tobacco use has steadily dropped in California to the point that the state boasts one of the nation’s lowest smoking rates. More than a quarter of California residents smoked in the mid-1980s. That figure was sliced in half by 2012, according to California Department of Public Health data. The share of California high school students who had tried a cigarette recently has also plummeted.
But the rise of electronic cigarettes among young people has offset the diminishing appeal of conventional cigarettes. Federal statistics show that “vaping” by middle school and high school students tripled from 2013 to 2014. E-cigarettes heat a nicotine-laced liquid into a mist that can be inhaled and comes in an array of different flavors.
California officials have refocused their fight against youth tobacco use on vaping, with the California Department of Public Health launching a vivid advertising campaign likening e-cigarettes to tobacco products that hooked previous generations.
The vaping industry has increasingly showed its clout in the Capitol. Previous bills to regulate the product have failed; before it advanced to an Assembly floor vote, a bill this year prohibiting tobacco use at California’s professional baseball parks was amended to exempt electronic cigarettes.
Sen. Mark Leno, D-San Francisco, is carrying a bill to regulate e-cigarettes like other tobacco products, which Leno said should complement the effort to boost the tobacco age. The bill cleared the Senate and is pending in the Assembly.
“You can say what you like about e-cigarettes – they deliver nicotine and they addict a new generation to nicotine,” Leno said. “If (SB 151) goes forwards and ours doesn’t, we should all be concerned that those under 21 looking for their nicotine fix can legally gravitate to e-cigarettes.”
To lawmakers skeptical of efforts to raise the age, the prospect of new smokers is an inevitable cost of free choice. Assemblyman Matthew Harper, R-Huntington Beach, suggested that sustained efforts to limit smoking, with SB 151 marking the latest initiative, point to an ultimate goal of removing the option altogether.
“Where is the endpoint that the folks have here? Is it to make tobacco illegal in the state of California?” Harper asked. “If folks want to make smoking illegal they should just be plain and upfront about it.”