1. Presented by: Melitta A. Johnson, MHA, August 7, 2015
Increasing the Legal Age to Access Tobacco Products - An Introduction -
Presented by: Melitta A. Johnson, MHA, August 7, 2015

2. Smoking and Tobacco Use
Progress has been made since the 1st Surgeon General’s Report in 1964
The rate of tobacco use has declined from 42% in 1964 to 18% today
Yet, tobacco use is the #1 leading cause of preventable deaths
Half of those who smoke die of smoking-related illnesses
Nearly 500,000 deaths are attributed to tobacco-related causes
Yet, 42 million American adults and about 3 million middle and high school students continue to smoke

3. Tobacco Use Typically Begins at an Early age
Of the adults who smoke daily
Approximately 90% of adult smokers report smoking prior to the age of 18
Nearly 100% of smokers report smoking prior to the age of 26
Increasing legal age will likely prevent or delay initiation of tobacco use by adolescents and young adults

4. Smoking Causes More Deaths
Smoking kills
Smoking
HIV
Illegal drug use
Alcohol use
Firearms
Motor vehicle accidents

5. Smoking in the U.S.

6. Smoking in LA County

7. The Cost of Smoking and Tobacco Use
Tobacco industry
$9.17 billion
U.S.
$300 Billion
2013 figures

8. How Smoking and Tobacco Use Effect the Body

9. Why Do People Smoke? Diabetes Cancer Lung disease Fertility issues
Heart disease
Fertility issues
Diabetes
Social pressures
Social rewards
Parental/family influence
Marketing
Stress relief
Addiction
Everyone knows that smoking can lead to each of these things, but why do people still smoke?

10. Food and Drug Administration and Institutes of Medicine Committee
In 2009, the Family Smoking Prevention and Tobacco Control Act granted the FDA authority over tobacco products
In March 2015, the Institutes of Medicine concluded that raising the legal age to access tobacco products will have positive impact on public health and save lives.

11. Public Health Implication of Raising Legal Age of Smoking
Institutes of Medicine identified some predictors of public health outcomes. They include:
Tobacco use initiation
Developmental biology and psychology
Tobacco policy
In 2009, the Institutes of Medicine created a committee to determine the public health implications of raising the minimum legal age to access tobacco products

12. Prefrontal Cortex and the Adolescent Brain
Prefrontal cortex: The part of the brain for
Decision-making
Impulse control
Sensation-seeking
Peer pressure susceptibility
Emotion control
The prefrontal cortex fully develops after adolescence
Tobacco initiation primarily effects adolescents and young adults because their ability to make sound decisions & control peer pressure influences has not yet fully developed

13. How Do We Reduce Tobacco Use Initiation Rates?
Continued tobacco cessation efforts at the city, county and state level
Increasing advertisements that discourage tobacco use
Partnerships with cancer societies
Raising the legal age to access tobacco products from 18 to 21
Adolescents years of age will be most impacted by an increase in the legal age
The majority of underage users rely friends that are over 18 to obtain tobacco products (i.e. other high school students/peers)

14. Tobacco Policy
State and local municipalities have the power to control the legal age for tobacco use
Hawaii became the first state to increase the minimum age from 18 to 21 (effective January 2016).
At least 80 localities in 8 states have already increased minimum legal smoking age, including New York City
Tobaccofreekids.org
CDC July 2015

15. Conclusion Raising the legal age for tobacco use will save lives by:
Reducing the rate of initiation
Reducing the number of tobacco users
State and local governments have the power and authority to increase the legal age to access tobacco products
The public health impact will depend on state and local initiatives that lead to smoking cessation

16. Philip Morris
“Raising the legal minimum age for cigarette purchaser to 21 could gut our key young adult market (17-20) where we sell about 25 billion cigarettes and enjoy a 70 percent market share.”
- Philip Morris report, January 21, 1986