I have a long history of working in tobacco prevention and control in North Dakota, and recently I’ve had many ask about the new age 21 tobacco legislation.
Here’s what I can tell you based on what I know:
Although tobacco initiation is a “choice,” the addiction rate is over 90% (alcohol by comparison is 8-14%). Death rates are over five times higher than alcohol, too, with 480,000 vs about 88,000 annually. Most with nicotine addiction are addicted by age 18.
Tobacco-related diseases are incredibly expensive to society. In North Dakota alone, we spend about $350,000,000 a year. No, smokers don’t pay for themselves with taxes — not even close. North Dakota only takes in about $15-20 million a year in tobacco tax.
Almost all of this is data is easy to find. The CDC maintains a large database, as does the U.S. surgeon general, University California-San Francisco (especially Dr. Stanton Glantz), and Mayo Clinic's nicotine addiction treatment center.
The thinking is that increasing the age of purchase to 21 will lower addiction rates. Now, I’ll admit the evidence is preliminary for this, though it’s hard to imagine a downside. We know regulation works. In 1965, 41% of all adults smoked. Today, it's about 17%, almost all due to increasing regulatory environment and better education for the public.
We don’t know yet what the final impact will be, because it takes years to assemble evidence-based data. Smoking rates have been declining, and raising the age will help continue that trend.
Anything we can do to keep young people from getting addicted is worth trying.