DEPARTMENT: Health
DEPARTMENT HEAD: Colleen M. Bridger, MPH, PhD
COUNCIL DISTRICTS IMPACTED: City Wide
SUBJECT:
A briefing on the Tobacco 21 initiative
SUMMARY:
The San Antonio Metropolitan Health District will provide a presentation, briefing the Community Health and Equity Committee on Tobacco 21. The presentation will include greater detail on the initiative as requested by committee members during a previous meeting.
BACKGROUND INFORMATION:
Tobacco use is the leading cause of preventable disease, disability, and death in the U.S., according to the CDC. National data show that 95 percent of adult smokers begin smoking before they turn 21. The ages of 18 to 21 are a critical period when many smokers move from experimental smoking to regular, daily use. People who have not used tobacco by age 21 are not likely to ever start. Increasing the tobacco age to 21 will help to prevent young people from ever starting to smoke and to reduce the deaths, disease and health care costs caused by tobacco use.
Tobacco use is associated with cancer, heart disease, behavioral and learning disorders, drug use, and pregnancy complications. Tobacco use causes half a million deaths annually and has been responsible for 20.8 million premature deaths in the U.S. over the past 50 years since the first Surgeon General’s report on smoking in 1964. Nationally, the current amount of health care and lost worker productivity costs each year related to tobacco use is $300 billion, according to the U.S. Department of Health and Human Services.
Individuals who begin smoking at a young age are more likely to become addicted, progress to daily smoking, become heavier tobacco users as adults, and have difficulty quitting. The U.S. Surgeon General has expressed concern about the potential long-term cognitive effects of exposure to nicotine during brain development with the potential for lasting adverse consequences.
Young teens often turn to older friends and classmates as sources of cigarettes. Increasing the tobacco age to 21 would reduce the likelihood that a high school student will be able to legally purchase tobacco products for other students and underage friends.
Tobacco 21 policies raise the minimum legal sale age of tobacco products to age 21. Today, 25% of all Americans are already covered by the more than 260 municipalities and 5 states that have passed laws raising the minimum age of purchase for tobacco products to 21.
Council Action History:
The Tobacco 21 policy initiative was first brought to the Council’s attention when Metro Health presented during the City Council Budget Work session on August 22, 2017, and then again at the first Community Health and Equity Committee meeting on August 24, 2017 both as a public health solution to the rates of smoking in high-school aged students as well as a part of a discussion of nine policy areas in the CityHealth initiative. During the Community Health and Equity Committee meeting, Council Members asked for additional information on this policy.
Public Input Process:
An online survey is being conducted by Metro Health to gauge the support of the community for this policy. As of October 18, 2017, we received 4,531 responses. These responses were 77% in favor of increasing the minimum age to purchase tobacco to 21. Metro Health is planning on hosting a community input meeting in November.
ISSUE:
The latest local statistics available show that in 2013, 12.6% male and 9.9% female Bexar County high school students currently smoke. Nationwide, a new trend emerged in 2014; for the first time in decades, the overall nicotine and tobacco use increased among U.S. high school students. This was found to be almost entirely due to an explosion in teen use of e-cigarettes, hookahs and vaping.
The City of San Antonio, as a home rule city within the State of Texas, has the authority to raise the minimum legal age of sale, purchase or possession of tobacco products to age 21. Tobacco products, as defined for these changes, include cigarettes, cigars, pipe tobacco, chewing tobacco, snuff, snus, or electronic smoking devices or the liquids in these devices.
This policy change will benefit the youth in the City of San Antonio, leading to fewer young people using tobacco products both immediately and over the course of their lives. In 2015, the Institute of Medicine concluded that raising the minimum legal sales age for tobacco products nationwide will reduce tobacco initiation, particularly among adolescents aged 15 to 17, improve health across the lifespan, and save lives.
ALTERNATIVES:
This item is for briefing purposes only.
FISCAL IMPACT:
There is no fiscal impact at this time.
RECOMMENDATION:
Staff recommends the Community Health and Equity Committee forward this item for a full City Council B Session presentation in November.