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February 26, 2018

Lawmakers in Arizona are considering increasing the age to purchase tobacco products from 18 to 21 years old. The proposal would also include a civil fine for persons under 21 who are found possessing tobacco products. Similar legislation failed in 2017.


Proponents say the change will help deter youth from smoking, but these proposals extend to other tobacco and nicotine products, including e-cigarettes and smokeless tobacco, thereby discounting the public health benefits provided by such products. Increasing the tobacco age would limit adults’ choices and negatively impact the state through lost revenue by creating an incentive for adults to purchase tobacco, e-cigarettes, and vaping devices in neighboring states or online.


In every state, individuals are considered adults at 18. They can serve in war; are tried as adults in courts; can accumulate massive debt in contractual agreements, such as student loans; and 18-year-old males are required by the federal government to sign up for the draft. If these individuals can accommodate these “adult” privileges, why would the government disallow them the choice to use tobacco products or products that might help them quit smoking cigarettes?


Evidence used to defend proposals that would increase age limits is circumstantial, at best. According to the National Institute on Drug Abuse, 58 percent of high school seniors reported using alcohol in 2015, and 35 percent reported using marijuana. Both of these are illegal to persons 21 years and younger, yet age restrictions did not halt consumption.


Further, 90 percent of tobacco users started smoking before age 18, according to the Centers for Disease Control and Prevention. Those under 18 also rely on “social sources” for tobacco products, including siblings, friends, parents and strangers; age restrictions will fail to address this problem as well. The U.S. Drug and Food Administration found “86% of 15 to 17 year olds obtained cigarettes” through these social sources.


Perhaps the most troubling issue with the proposal in Arizona is the inclusion of tobacco harm reduction (THR) products, including smokeless tobacco, e-cigarettes and vaping devices. Growing research continues to indicate that these products have proven to be a safer alternative to combustible tobacco smoker and have helped thousands quit smoking.


Smokeless tobacco products, such as snus, deliver nicotine in a safer manner compared to combustible cigarettes. In 2009, BioMed Central analyzed “the relative risk of cancer among smokeless tobacco users, compared with non-users of tobacco.” The authors found “very little risk” of smokeless tobacco producing elevated risks. Dr. Brad Rodu, a senior fellow at The Heartland Institute has over 20 years of research on the health effects of smokeless tobacco. Analyzing data from Sweden, Rodu found “Swedish men have the highest rate of smokeless tobacco use in Europe, which is directly linked to the lowest smoking rate on the continent. Swedish men also have the lowest rates of lung cancer and other smoking-related diseases in Europe.”


Other THR products include e-cigarettes and vaping devices, which have helped thousands of people quit smoking combustible cigarettes. Public health organizations around the world have noted these products are significantly safer than combustible tobacco cigarettes.  In 2017, NHS Health Scotland declared vaping “less harmful than smoking.” In 2016, the Tobacco Advisory Group of the Royal College of Physicians in the United Kingdom concluded the health risks of THR products are “unlikely to exceed 5% of the harm [caused by] smoking tobacco.” In 2015, Public Health England asserted e-cigarette us as roughly “95% safer than smoking.”


Other research indicates the use of THR products could also help aid states’ budgets. Research by J. Scott Moody, chief executive officer and chief economist at State Budget Solutions, concluded Medicaid could have saved an estimated $48 billion in 2012 if e-cigarettes had replaced combustible cigarettes used by current Medicaid recipients who consume tobacco products.


Lawmakers in the Grand Canyon State should not limit adults’ choices by increasing the age to purchase and possess tobacco products. Rather, policymakers should implore the use of THR products such as smokeless tobacco and electronic cigarettes, as these have proven to be effective tools for combustible cigarette cessation.

Nothing in this Research & Commentary is intended to influence the passage of legislation, and it does not necessarily represent the views of The Heartland Institute or Tobacco Harm Reduction 101.

Centers for Disease Control and Prevention Link Majority of Vaping-Related Hospitalizations to THC: Welcome
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