Waiting to Inhale: Lawmakers Consider Raising Smoking Age to 21 | Health Care | Seven Days | Vermont's Independent Voice

News + Opinion » Health Care

Waiting to Inhale: Lawmakers Consider Raising Smoking Age to 21


  • Sean Metcalf

Rep. George Till (D-Jericho) is on a mission to deter tobacco use in Vermont.

For the past three weeks, the 63-year-old four-term lawmaker has been doggedly lobbying his House colleagues with a proposal to raise the age at which Vermonters can legally buy and use tobacco products, from 18 to 21.

That he's a physician at the University of Vermont Medical Center only half explains Till's push for that bill, another that would regulate electronic cigarettes the same way as tobacco products and a third to hike tobacco taxes.

For Till, it's also personal: Smoking killed both of his parents when they were in their sixties.

"It is a really ugly way to go, dying of emphysema," he said. "It is horrible to watch. It is even more horrible to go through."

Till can present facts about tobacco use with the precision you expect from a scientist. An estimated 10,000 youngsters who smoke today will die from tobacco-related illnesses, he has said in testimony and floor speeches. Direct medical costs for smoking-related illnesses in Vermont total $348 million a year.

"Ninety percent of adult smokers started by they time they were 21, and 99 percent by 26," he explained. "So if you don't start young, you are much less likely to become addicted."

Till first proposed raising the smoking age to 21 in 2014, but his bill failed to receive consideration. He offered the measure again last year, and once again nothing happened. As this legislative session reached its midpoint, the bill was still stuck in committee.

But a proposal to place restrictions on electronic cigarettes was in play. In it, Till saw an opportunity to test the chances of raising the legal smoking age. He asked, "Why would we not embrace this?"

First he tried to persuade the House Human Services Committee to add the age change as an amendment to the e-cigarette bill. The panel turned him down, because some members worried that the measure might jeopardize passage of the e-cigarette restrictions.

Till didn't give up. He offered the same amendment when the e-cigarette bill came before the full House. The March 16 vote was 71-71. House Speaker Shap Smith (D-Morristown), who is not a fan of the change, declined to cast a tie-breaking vote, so the amendment died.

Till put a positive spin on the loss. He said the tie vote sent a message to House leaders that "People want this to happen."

It convinced Rep. Ann Pugh (D-South Burlington), chair of the Human Services Committee, to schedule testimony on Till's stand-alone bill last Thursday. Her committee voted to advance it, 7 to 4.

Till won another small victory late last week for a proposal to impose an excise tax on e-cigarettes, just as the state does on tobacco products. He wanted to add it to a bill already full of tax changes, but Smith stymied this effort with a surprise ruling that the amendment wasn't relevant.

Till asked for a vote to overrule the speaker, but House Ways and Means Committee chair Janet Ancel (D-Calais) had another idea. She called a quick committee meeting and had the tax-writing panel vote out an e-cigarette excise tax bill that would raise $500,000. "I feel the issue deserves a vote," she said.

Till said that such antismoking measures are "things that we know work and can reduce personal suffering."

The movement to raise the smoking age began a decade ago when a Boston suburb bumped up the minimum age for tobacco sales from 18 to 21. Subsequent research found that by 2010, the teen smoking rate in Needham had dropped from 13 percent to 7 percent.

Since then, more than 90 Massachusetts municipalities have raised their smoking ages to 21. So have Cleveland, Kansas City, San Francisco and New York City. Chicago aldermen approved the change on March 16.

Hawaii became the first state to switch to 21, in 2015. Lawmakers in California approved the change earlier this year, and their bill awaits the governor's signature.

Antismoking advocates in the Vermont Statehouse want to increase the age here, too, but their priority this year has been enactment of e-cigarette restrictions. Rebecca Ryan, public policy director for the American Lung Association in Vermont, said upping the smoking age is a relatively new idea bolstered by a recent National Academy of Medicine report. It found that within the first five years, an increase in the legal smoking age would reduce the number of U.S. youth who try smoking by 25 percent, drop overall smoking rates by 12 percent, and avert 16,000 cases of premature and low-weight babies.

The Coalition for a Tobacco Free Vermont, which includes the Lung Association, the American Heart Association of Vermont and the American Cancer Society Cancer Action Network, laid much of the groundwork with lawmakers on the e-cigarette bill. Those lobbyists don't want to lose momentum by tying it to a newer, more controversial proposal.

"We support both policies, but we want to see them stand alone," Ryan said.

The e-cigarette bill, which has passed the House and is under review in the Senate Health and Welfare Committee, would prohibit the use of these electronic devices wherever lit tobacco products are banned, such as in restaurants, public buildings and motor vehicles when young children are passengers. It also would require retailers to remove e-cigarettes from counter displays.

Advocates and Health Commissioner Harry Chen argue that e-cigarette restrictions are urgently needed. According to the 2015 youth health survey in Vermont, 15 percent of high school students say they use e-cigarettes, compared to 11 percent who say they smoke, Chen told the Health and Welfare Committee. "Adult use is also increasing," he said.

E-cigarettes, which have battery-powered heating elements to vaporize liquids that users inhale, often contain nicotine, which is addictive, Chen said. They come in thousands of flavors — including bubble gum and cotton candy — which the Lung Association's Ryan said makes them more appealing to young people.

Linda Barker, who works at Vermont Vapor in Castleton, argued that e-cigarettes help smokers quit. She told the Health and Welfare Committee she smoked for 41 years until she tried e-cigarettes. Curious, she conducted her own anecdotal research on Vermont Vapor customers over a three-week period. She found that just four of 95 who vape also smoke.

"You are vilifying e-cigarettes," she said of the pending bill. The proposed restrictions on where people could use the devices "would drive us back with smokers when we have quit," she argued.

Dr. Jan Carney, associate dean for public health at the University of Vermont College of Medicine and former health commissioner, disputed Barker's assertions that e-cigarettes help people quit smoking. She said research shows "the majority of people smoking e-cigarettes are continuing to use traditional cigarettes."

Sen. Ginny Lyons (D-Chittenden) asked if the scientific evidence on e-cigarettes showed them to be hazardous enough to warrant the restrictions in the proposed bill.

"The more we learn, the more concerned we are," Carney responded.

Antismoking advocates at the Statehouse shuttle between Senate deliberations on the e-cigarette bill and the House, where Till's age-change bill is moving. The version that passed the Human Services Committee last Thursday would raise the legal smoking age incrementally over the course of three years, beginning in January 2017. Rep. Jill Krowinski (D-Burlington) said the phase-in approach was designed to protect today's 18- and 19-year-old smokers from having their rights revoked.

Jim Harrison, president of the Vermont Retail & Grocers Association, opposed the phase-in, saying it would be challenging for retailers to keep track of dates when the legal age for sales changed. He argued, too, that Vermont should wait until surrounding states made the change to minimize lost sales to border businesses.

The bill's opponents on the Human Services Committee questioned the fairness of telling 18-year-old military members that they can risk their lives for their country but not their lungs to cigarette smoke. Rep. Francis "Topper" McFaun (R-Barre Town) tried but failed to win support for an exception for members of the armed services.

Citing the testimony of pediatrician Dr. Barbara Frankowski, McFaun suggested the age should be higher — specifically 26, when the young, addiction-susceptible brain is considered fully developed.

Rep. Paul Dame (R-Essex Junction) argued, "I'm not sure that the way to get 18-year-olds to make better decisions is to take decisions away from them. Aren't we only encouraging this idea of delayed adolescence?"

The full House had been scheduled to vote Tuesday on raising the smoking age, but when questions arose about the potential tax loss, House leaders agreed to send the bill to the Ways and Means Committee.

On Wednesday, the e-cigarette excise tax bill Till cosponsored comes up for its first vote in the full House.

Neither has a clear path to enactment, because they missed the Senate crossover deadline. But House Speaker Smith said that if the upper chamber sits on the bill because of its tardy arrival, "it is possible it could end up on another bill." Smith is against the change on the same grounds as McFaun and, using the same logic, believes the drinking age should be 18.

Even if it wins legislative approval, Gov. Peter Shumlin might veto it. "The governor is opposed to this bill in a very strong way," Health Commissioner Chen told the Human Services Committee.

Personally, Chen, a doctor, acknowledged, "It would be impossible for me to absolutely oppose this."

Till is grateful that his tobacco bills are finally being taken seriously but remains realistic about their chances of making it all the way this year. The age-change proposal is new to the Senate, so education will be critical, he said.

"Raising the smoking age is so obviously good policy for population health and disease prevention that it will happen in Vermont sooner or later," Till said. "I just hope for it to be sooner."