Doctors support raising the smoking age

Teenagers looking to buy cigarettes in New York may have to look elsewhere if a city council proposal is approved and signed by Mayor Michael Bloomberg. The proposal would raise the legal age to buy any form of tobacco from 18 to 21. But will it be effective in limiting smoking among young people?
Approximately 90% smokers have already started smoking by age 18, according to the Surgeon General.
"Of every three young smokers, only one will quit, and one of the remaining smokers will die from tobacco-related causes," according to the Surgeon General's 2012 report, "Preventing Tobacco Use Among Youth and Young Adults."
The key is to "try to reduce the number of young people who ever try a cigarette," said Dr. Michael Steinberg, director of the Tobacco Dependence Program at Rutgers University in New Brunswick, New Jersey.
Steinberg is the co-author of a commentary published Monday in the Annals of Internal Medicine that looks at the pros and cons of the New York proposal. Critics say small businesses will suffer, and the city will lose tax revenue. Others say the proposed law will be hard to enforce and will impinge upon individual rights.
But Steinberg argues teens need help to avoid picking up the habit.
"I think a 21-year-old is much more likely, based on their maturity and life experiences, to be able to make an informed rational decision about a behavior that might affect the rest of their life than, say, an 18-year-old," Steinberg said.
He said that an 18-year-old is not necessarily thinking about the risks associated with smoking.
"Cigarettes and tobacco contain some of the most addictive chemicals in our society," said Steinberg. "Smoking a cigarette delivers more nicotine more efficiently to your brain than if you were to inject nicotine intravenously."
The New York proposal was introduced in April by Dr. Thomas A. Farley, the city's health commissioner, and Christine C. Quinn, City Council speaker and a mayoral candidate. A vote on the proposal is expected to take place this fall, according to a spokesperson from the City Council's office.
Federal law prohibits the sale of tobacco to people under the age of 18. Alaska, Alabama, Utah and New Jersey require people to be 19.
Officials in New York estimate that raising the purchasing age to 21 will cut tobacco use by 55% among 18- to 20-year-olds and lead to a 67% drop among teens aged 14 to 17 years.
Steinberg knows that limiting access to tobacco is not the only strategy for reducing youth smoking, but it's a start.
"It's not going to fix the problem in and of itself," said Steinberg. "You also need educational programs."
The U.S. Preventive Services Task Force, a panel of health care experts, now recommends that primary care physicians offer patients interventions, education and counseling to prevent tobacco use among children and adolescents.