George Till: The case for tobacco 21

Editor’s note: This commentary is by Rep. George Till, D-Jericho, a doctor.

Raising the minimum age to buy tobacco to 21 would save lives by preventing adolescents from ever taking up smoking. It is the best way to prevent lifelong addiction, associated chronic disease and suffering.

Right now in Vermont, the healthiest state in the nation, there are nearly 10,000 kids under 18 years old who will die prematurely from tobacco-caused illness, if we do nothing. About three out of four teen smokers end up smoking into adulthood. Among youth who persist in smoking, a third will die prematurely from tobacco-related disease. Smokers die on average 10 years earlier than nonsmokers and 1 in 5 deaths in this country are tobacco-related.

The key point is that if people get through adolescence without smoking, it is highly unlikely they will ever start. The flip side is if they do start smoking in adolescence, everything we have learned about teen brain development shows that it will be much more difficult for them to stop. Nicotine’s effect on brain development leads adolescents to heavier daily tobacco use, a stronger nicotine addiction and more trouble with quitting later in life. Ninety percent of cigarettes supplied to teens come from 18- to 20-year-olds, so raising the minimum sales age to 21 puts legal purchasers outside the social circle of most high school students. The result is that the age group most who benefit most are those between 15 and 17 years old, who no longer get easy access to tobacco products.

Nicotine’s effect on brain development leads adolescents to heavier daily tobacco use, a stronger nicotine addiction and more trouble with quitting later in life.


We know raising the smoking age works. In 2005, the Boston suburb of Needham raised the age for tobacco sales to 21. With no other changes, rate of smoking in the past 30 days decreased 50 percent and frequent smoking decreased 62 percent compared with surrounding towns. Anyone who claims that 18- to 20-year-olds will just go across the state line to buy tobacco products has to explain why the data shows they didn’t even go across the town line in Needham to make purchases for the past 10 years. Now two states, Hawaii and California, as well as 200 cities and towns across the country have raised the age to 21.

Yearly, Vermonters spend $348 million on direct medical costs of tobacco-related illness. Whether it is through increased health care premiums or through tax dollars, Vermonters pay that $348 million each and every year. These are preventable expenditures and this is the low hanging fruit for reducing health care spending. On top of direct medical costs, Vermont’s economy suffers another $250 million in lost productivity due to tobacco, bringing the total yearly expense to $600 million.

A 2015 study by the Centers for Disease Control and Prevention (CDC) found 75 percent support for tobacco 21 including 70 percent of smokers and 64 percent of 18- to 24-year-olds. The immediate effect on retailers is minimal since only 2 percent of overall tobacco sales go to 18- to 20-year-olds. The cost to the state is a small loss of tobacco tax revenue. The health care savings are enormous. The savings begin almost immediately with a reduction of preterm births and growth-restricted fetuses. Tobacco is responsible for 30 percent of fetal growth restriction and 15 percent of preterm births. There would also be a major reduction in crib deaths.

According to the CDC, Vermont has a higher smoking rate than New York, New Jersey, Massachusetts, Connecticut, Rhode Island, and even Texas. With tobacco 21 we have a tool which can provide major reductions in tobacco addiction, suffering from tobacco related diseases, premature death, and save Vermonters hundreds of millions of dollars in both health care premiums and taxes. We can’t afford to not pass tobacco 21, either morally or financially.

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  • Dave Bellini

    Some drug stores have stopped selling tobacco products. Kudos to them. It would be a step forward if some of the convenience stores did likewise.

  • Andrew Fusco

    An altruistic proposal, but flawed.

    If you can vote, join the military, pay taxes, and take out a student loan, then you’re an adult who has the right to buy tobacco. And beer, for that matter.

    Is the age of majority 18, or 21 in this country? What defines adulthood? We should be more consistent in this regard.

  • Excellently put. These statistics speak for themselves. I might add that we need to increase the tax on cigarettes by $1.00 as the statistics also show that the rate of smoking in youths is reduced by this measure as well. Refunding the Vermont Tobacco Review Board will also help contribute to reducing tobacco use by Vermonters of all ages.

    • Randy Jorgensen

      Why $1.00 why not $5.00, $10.00?

      Why not just outlaw it and be done with it? Why use a tax as a means of behavior modification? IF you are are hell bent on not wanting adults the choice to smoke (I’m an x smoker of 21 years BTW) then outlaw it. They’re dry towns, why not have a tobacco free state?

      • Elizabeth T. Lane

        I agree with you Mr. Jorgensen but I do have one comment. You asked “why not have a tobacco free state?”
        I think New Hampshire would be over the moon if we did this. We already have many Vermonters shopping in NH. I just bought a car and winter clothing this weekend.

      • Doug Hoffer

        The State does not have the authority to outlaw cigarettes.

        • chuck drake

          The State is the people. If the people want cigarettes to be illegal you’d be surprised how fast legislators can act to maintain their elected position.

          • Randy Jorgensen

            In the broad sense Doug is most likely correct.

            My hunch, and it’t nothing more then that is VT could probably ban the sale of cigarettes but probably not the possession of them. Much like you can’t legally buy Everclear 195 in every state in the US except two: Texas and Rhode Island, however the possession of it isn’t illegal.

            Or for instance you VT’s fireworks law: Legal to purchase, but illegal to posses without a permit. Go figure.

            “According to state law, fireworks can be sold legally but are illegal to possess, transport or use unless the local fire chief signs a permit. “

    • michael olcott

      Something i almost never see suggested is that we mandate the slow elimination of the drug nicotine from tobacco products,say over 5-10 years. the 2 solutions that we keep trying have a minimal effect and only tax the poorest into bad decisions and further isolate them from the rest of society ( no smoking darn near everywhere,whats next a smokers license? j/k) due to their addiction. eventually the elimination of the most addictive part of the habit will be gone and then its just the mental part of quitting we would have to deal with.

  • Matt Fisken

    When a pack of smokes is legal for an 18 year old to buy, but not a beer, cigarettes become the default vice for our youth. They lead to poor health, poor nutritional habits, wasted income, and other addictions down the road.

    This should be such common sense, but of course, “this is Vermont and we do what we want!”

  • Neil Johnson

    It would be nice if we raised the age of consent or becoming an adult to one age (perhaps 20?), for everything, military, liquor, cigarettes, debt, marriage etc.

    One age for everything, it could be 18, but I cringe looking at my nieces and nephews signing up for the draft at 18. We should have one age, what ever it may be, if your an adult, you’re an adult with all the freedoms and RESPONSIBILITIES. If we educated our children better about the realities of life surely they would be better off.