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MyView: Raising the tobacco purchasing age

November 06, 2017

By Nevin Zablotsky, D.M.D.

Photo of Dr. Zablotsky
Nevin Zablotsky, D.M.D.

There is an old expression that always seems to bring me back to earth when I get overly optimistic about what I can accomplish in my line of tobacco cessation work.

"Man plans and God laughs." I don't think you have to be religious to get the gist of this statement, just one who understands the hubris of we human beings.

I think there finally is a consensus in this country that the use of tobacco products is harmful to one's health. It took legitimate scientific research, numerous Surgeon General's reports, dedicated health advocates and effective legal teams to get there, but it seems that even the big tobacco companies now admit that perhaps the use of their products just might kill you sooner or later.

Despite this fact, we as a society still say that these products can still be legally sold in this country and that by the age of 18 we are wise enough to decide whether we want to go down that tobacco road or not. As of this writing, California, Hawaii, Maine, New Jersey and Oregon have raised the age of purchasing tobacco, along with New York City, Boston and Chicago.

Over the years, I have volunteered to speak to Vermont junior and senior high school students about the dangers of the use of tobacco products. I tried to make these talks interactive and saw that the main motivations for using cigarettes and smokeless tobacco was peer pressure and the desire to be cool. Many students didn't succumb to this pressure, but unfortunately too many did.

There are so many reasons for dental professionals to take a stand on raising the legal smoking age to 21. Some of these include the following:

  1. Studies have shown that maternal smoking, be it passive or active, may be associated with an increased risk of cleft lips and palates in offspring.
  2. There is a higher incidence of dental caries seen in those using tobacco products.
  3. The 2016 Surgeon General's report stated that there is a causal relationship between smoking and periodontitis.
  4. Smoking increases the risk of implant failure.
  5. Leukoplakia occurs 6 times more frequently in smokers versus non-smokers.
  6. The American Cancer Society estimates that 49,670 people will get oral and pharyngeal cancer in 2017, with 9,700 dying from the diseases. The risk of developing oral cancer is much greater in tobacco users as 75 percent use tobacco products.
  7. Smoking will also be the cause of one out of three of all cancer deaths, as it is known to cause cancer of the larynx, lung, bladder, pancreas, cervix, kidney, stomach, blood, liver, colon, rectum and the esophagus, to name a few.

Opponents of raising the smoking age to 21 state that if you are old enough to vote you should be capable of deciding whether to smoke or not. Studies have shown that most smokers begin smoking during adolescence and the exposure to nicotine during this period impairs the developing brain. Are we willing to watch kids' brains be compromised for the decisions they made before they turned 21?  

It has been shown that nearly everyone who buys cigarettes for minors in the U.S. is under 21 years of age. Raising the smoking age prevents high school students form buying tobacco for their peers. It has been shown that half of adult smokers become regular smokers before the age of 18 and four out of five become regular users before they reach the age of 21. Raising the age to 21 will reduce the number of nicotine dependent adults.

Another argument by opponents of raising the age is that if you are old enough to serve in the military you are old enough to use tobacco. In the 1980s, the Department of Defense increased health promotion efforts and set in place programs to curb tobacco use in personnel. It was shown that soldiers that smoked, exercised less, performed more poorly on physical fitness tests and were less successful in combat training.

The National Academy of Medicine states that an increase in the purchase age of tobacco products would have an immediate effect in improving maternal/fetal and infant outcomes. Raising the tobacco age to 21 protects moms and babies.

Finally, It has been estimated by the Tobacco Free Kids researchers that 5.6 million kids now under 18 and alive in the U.S will ultimately die prematurely from smoking. These deaths are preventable. I urge all dental professionals to contact their state representatives to consider raising the age of tobacco use to 21.

They will improve the oral health of their constituents not to mention spare them from debilitating chronic diseases and even death.

Finally, On Nov. 16, smokers across the nation will take part in the American Cancer Society Great American Smokeout event. Dental professionals should encourage their patients and friends to use this date to make a plan to quit, or plan in advance and then quit smoking at least for that day.

Dr. Zablotsky is a senior consultant and lecturer at the Nova Southeastern College of Dental Medicine and lectures internationally on tobacco.