Today we work in smoke-free offices, eat in smoke-free restaurants, and view cigarettes as a vice of the few — not an acceptable practice of the many.
Yet the days when smoking was acceptable were not so long ago. I remember when I started working in a small New Jersey law firm in 1993. Lit cigarettes regularly sat in ashtrays and sent pungent smoke through the air. Requesting a colleague not smoke — even in a windowless conference room — was considered rude.
Even years later, while I was pregnant, clients would regularly light up during a lunch meeting and even in my car.
We’ve experienced a striking cultural shift. The percentage of Americans who smoke declined from 42 percent in 1965 to less than 15 percent today.
But the change did not just happen. Every single measure to reduce smoking was hard-fought. Every single measure: restrictions in tobacco advertising, warning messages on cigarette packages, clean indoor air laws, age restrictions on tobacco sales, health education initiatives.
The fight continues and remains as difficult and complex as ever. Perhaps you’ve read that Gov. Christie recently rejected a bill to raise the age to purchase tobacco or vaping products from 19 to 21. I sit on Princeton’s Board of Health and the same issue came before us. I voted differently, and would like to share my perspective.
Let me start by saying I struggled with this issue and was at first very skeptical. Is this a “nanny state” response to a public health issue? Why can’t legal adults make a decision about smoking for themselves? I also thought about the inconsistency of letting people vote or serve in the military while not allowing them to buy a pack of cigarettes at their local convenience store. And the patchwork of local government rules rather than statewide consistency bothered me.
But I dug into the facts.
Cigarette sales to those under 21 comprise just over 2 percent of sales. But because 90 percent of smokers start by the age of 21, these sales create 9 out of 10 future smokers, according to the organization, Tobacco 21. The organization cited the example of Needham, Massachusetts, which from 2005-2008 gradually raised the legal age to purchase tobacco products to 21. No one expected much to change since any 19-year-old who wanted to buy cigarettes could simply head to the next town.
Yet something did change in Needham. The youth smoking rate of 13 percent dropped to 6.7 percent, a decline that was triple the decline of nearby towns. The thinking is that smoking among young people is not powered by illegal sales — but by legal sales to older youth who share cigarettes with younger teens. Raising access to age 21 puts legal purchasers outside the social circle of most high school students, according to Tobacco 21.
Ninety five percent of smokers begin smoking before the age of 21. The Institute of Medicine concluded that raising the legal age to 21 would result in a 25 percent decrease in smoking among 15-17- year olds. And remember there is no redeeming value in smoking. Smoking is physically addictive, especially to young brains, and leads to more health consequences than I can even begin to list here.
New Jersey allows towns to create more stringent laws regarding the sale of tobacco. I am proud that I helped Princeton establish 21 as the minimum age. Other towns that also have raised the age to 21 include Bogota, East Rutherford, Englewood, Garfield, Highland Park, Sayereville and Teaneck.
A statewide law is the best way to move forward. But if that does not happen — or does not happen soon — towns across the New Jersey have the power to save lives and protect the teenagers in their communities from a powerfully addictive and unhealthy practice. They should use it.
Linda J. Schwimmer is President & CEO of the New Jersey Health Care Quality Institute