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Raising legal age to buy tobacco is a good start

Q: I heard that there is a new federal law to increase the legal age to purchase tobacco to 21. Is this really necessary?

A: If you want to keep teens from becoming smokers and prevent many serious health issues that are a significant burden on our country, then yes, this is absolutely necessary. The federal law was signed by President Trump on Dec. 20 and has made it illegal to sell any tobacco products (including cigarettes, e-cigarettes/vaping products, and cigars) to anyone under 21.

Before the federal law was signed, the U.S. already had 19 states, Washington D.C., and over 500 cities that had passed legislation to raise the legal age of purchase of tobacco products to 21. New Mexico has some proposed legislation, HB 66, that is aiming to accomplish the same goal at a state level. Federal law is now in effect with details on implementation to come from the Food and Drug Administration (FDA). Now that the federal legislation has been signed, states that do not comply with this new law may lose significant federal funding.

The rates of teens who occasionally or even regularly use tobacco are alarming. Some statistics show that one in four 12th graders, one in five 10th graders, and one in 10 ninth graders have vaped nicotine in the last month.

The FDA and CDC recently released findings from the 2019 National Youth Tobacco Survey which showed high rates of e-cigarette use in middle and high school students, with more than five million reporting having used e-cigarettes in the past 30 days and nearly one million reporting daily use.

Over 90% of cigarette smokers tried smoking before they were 18, and most smokers who become addicted started before they were 21. Some evidence suggests that nicotine adversely affects brain development, which continues until an individual is 25, making it more addictive and more difficult to quit if initiated in the teen years. So, the most effective means to help teens stop using tobacco is to prevent them from starting in the first place.

According to data from the CDC website, smoking is the leading preventable cause of death in the U.S. Smoking causes an enormous health burden killing more than 7 million people worldwide and is responsible for nearly one in five deaths in the U.S. annually. This represents more than all the deaths from motor vehicle injuries, firearm-related incidents, illegal drug use, alcohol use, and human immunodeficiency virus combined.

It has caused premature death in 10 times as many citizens than have died in all of the wars fought by the U.S., and one in two smokers die from smoking-related illnesses. Smoking leads to lung cancer (causing almost 90% of all lung cancers) and contributes to 33% of all cancer deaths. It causes heart disease, stroke, chronic obstructive pulmonary disease (COPD), significantly increases an individual’s risk of getting diabetes, causes vision problems, affects the health of your teeth and gums, weakens bones, and contributes to arthritis.

For pregnant women, it can cause stillbirth, preterm delivery, low birth weight, and birth defects.

Secondhand smoke exposure in adults can also lead to cancer, stroke, and heart disease.

In children, it causes ear infections, respiratory infections, worsens asthma symptoms, and can contribute to sudden unexplained infant death syndrome (SUIDS).

Additionally, the U.S. has already had more than 2,500 cases of vaping-related lung injuries.

According to the American Lung Association website, “In March 2015, a report from the National Academy of Medicine revealed that “Tobacco 21″ could prevent 223,000 deaths among people born between 2000 and 2019, including reducing lung cancer deaths by 50,000.” The financial burden of smoking-related illness in the U.S. is more than $300 billion, which includes direct medical care costs and lost productivity from primary and secondhand smoke exposure.

While banning the sale of tobacco products to those younger than 21 is a good start, it will also be important to ensure that online purchasing of tobacco products is held to the same standard as in-store purchasing. The next most important step is to eliminate flavored nicotine products, especially those in vape devices and e-cigarettes, as these play a significant role in initiation of nicotine use and addiction in youth.

Other prevention strategies include creating smoke- and tobacco-free campuses, encouraging media and entertainment companies to decrease or remove tobacco imagery from video games/television/social media, and launching public awareness campaigns to prevent use of tobacco and provide cessation strategies. More information can be found at,,, and

Melissa Mason is a general pediatrician with Journey Pediatrics in Albuquerque. Please send your questions to her at