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Big Tobacco Attacks Sensible F.D.A. Rules on Vaping

As smokers turned to electronic cigarettes to reduce the health risks of smoking, big tobacco companies started buying e-cigarette makers and producing and selling their own. Now those companies are lobbying Congress to prevent the Food and Drug Administration from regulating electronic cigarettes and cigars, as it does conventional cigarettes. If they succeed, they will be able to sell and market addictive nicotine products to young people with few restrictions.

https://www.nytimes.com/2017/04/19/opinion/big-tobacco-attacks-sensible-fda-rules-on-vaping.html?_r=1

While promoters of e-cigarettes and e-cigars, which provide nicotine in vapor form, say they can help people quit conventional tobacco products containing harmful tar, there is not a lot of evidence for that claim. In addition, the devices are dangerous to young people because the nicotine they provide “can cause addiction and can harm the developing adolescent brain,” according to a 2016 report by the surgeon general, Vivek Murthy. Health experts also say that the vapor those devices produce can contain carcinogens and metal particles.

Another government report found that 16 percent of high-school students said they had used e-cigarettes in 2015, up from just 1.5 percent in 2011. The industry sells these products in a broad array of flavors, like gummy bear and cotton candy, designed to appeal to young people when they are more susceptible to becoming dependent or addicted to nicotine.

After years of deliberation, the F.D.A. said last May that it would begin regulating the manufacturing, sale, packaging and advertising of e-cigarettes, and all tobacco products, under a 2009 federal law that authorized it to do so. Specifically, the agency said it would begin reviewing the health risks of e-cigarettes introduced since early 2007, and potentially ban specific flavors and products that it deemed harmful. The tobacco lobby wants Republicans to amend a vital appropriations bill to exempt products that were introduced before May 2016 from F.D.A. review.

The push to undermine the F.D.A.’s authority began even before the agency had finished its rule. One Republican lawmaker, Representative Tom Cole of Oklahoma, introduced a bill in 2015 that was identical to a draft circulated by the Altria Group, the country’s biggest tobacco company and a marketer of vaping products. In addition to its legislative effort, the industry has also filed several lawsuits in federal courts challenging the rule.

Tobacco companies complain that the F.D.A.’s rule amounts to “retroactive” regulation because many of the e-cigarettes and e-cigars it will regulate have been on the market for years. But the industry has known for years that government officials were developing this rule. Large bipartisan majorities in Congress voted in 2009 to hand the agency the authority to evaluate and approve new tobacco products introduced on or after Feb. 15, 2007. The F.D.A. is simply doing its job by protecting public health.

Vaping Caused So Many Accidents the Navy Decided to Ban It

The men and women serving in the military have stressful jobs, and they all need to find ways to decompress. But if you’re a member of the Navy it looks like one of your recreational activities is off-limits, at least temporarily.

http://www.complex.com/life/2017/04/united-states-navy-bans-vaping

Bad news smokers: the Navy has banned vaping. Vaping on United States military ships and equipment has been problematic enough for concerns to make their way to the top of the naval totem pole. As of May 14, sailors will be banned from vaping on ships, subs, planes, boats, and all other official naval equipment.

The commanders of the U.S. Fleet Forces and U.S. Pacific Fleet provided a statement detailing the justification for the decision, saying, “The Fleet commanders implemented this policy to protect the safety and welfare of Sailors and to protect the ships, submarines, aircraft and equipment.”

If you’re immersed in Navy culture, this has been a topic of great debate for some time. The Naval Safety Center called e-cigarettes a “significant and unacceptable risk” in 2016, following a series of accidents involving the devices, and a memo from the Navy revealed at least 15 incidents —referred to officially as “mishaps”— in a span of eight months. In comparison to other lithium-ion devices, the Naval Safety Center pegged e-cigarettes in a class of their own because of their propensity to explode when dropped.

Some of the incidents are almost too crazy to be believed. In one issue of the Naval magazine Sea Compass, a story was shared of an incident with an e-cigarette that caused the total destruction of a car and first-degree burns on one of the passengers. It concluded with this passage:

This dramatically increases the risk of an explosion and a fire with disastrous consequences. All it takes is for one careless Sailor to mishandle a lithium ion battery, or to buy a cheap battery for their vape, and a statistically rare event can become a reality.

The higher-ups in the Navy looked at incidents like these and decided it was time to take the decision out of the hands of their sailors. They claim the ban will “remain in effect until a final determination can be made following a thorough analysis.”

Sailors will still be allowed to smoke real cigarettes in the designated smoke deck area, so smoking hasn’t been totally eliminated. But if vaping is near and dear to your heart, don’t enlist in the Navy any time soon.

U.S. Navy Bans E-Cigarettes After Multiple Sailors Suffer Serious Burns From Exploding Batteries

The United States Navy has placed an indefinite ban on the use of electronic cigarettes aboard its ships, submarines and aircraft after multiple sailors suffered serious injuries from the device batteries exploding and catching fire.

https://uk.news.yahoo.com/u-navy-bans-e-cigarettes-163102315.html

In a statement Friday, the U.S. Fleet Forces Public Affairs said that the policy had been implemented “to protect the safety and welfare of sailors and to protect the ships, submarines, aircraft and equipment.”

The ban, which will go into effect May 14 and “remain in effect until a final determination can be made following a thorough analysis,” will apply to the use of e-cigarettes by any personnel on Navy craft or equipment.

“This new policy is in response to continued reports of explosions of ENDS [Electronic Nicotine Delivery Systems] due to the overheating of lithium-ion batteries,” the statement continued. “Multiple Sailors have suffered serious injuries from these devices, to include first- and second-degree burns and facial disfigurement. In these cases, injuries resulted from battery explosions during ENDS use, charging, replacement, or inadvertent contact with a metal object while transporting.”

A memo from the Navy last September outlined the growing problem of vaping onboard Navy vessels and aircraft. The document stated that there had been 15 “mishaps” between October 2015 and June 2016, resulting in injuries to navy personnel or material damage to equipment.

Of the recent incidents, two required firefighting equipment to be used, with one resulting in an aircraft having to return to base due to smoke in the cargo section of the aircraft. Another ten occurred while the e-cigarette was in the pocket of a Navy sailor, which typically led to their clothing catching fire and first and second-degree burns on their legs and torso. Two further battery explosions happened when the e-cigarette was in the individual’s mouth, leading to facial and dental injuries.

After May 15, sailors will only be allowed to vape on shore in designated smoking areas.

The Navy is far from alone in experiencing problems with e-cigarettes. A man who suffered similar burns when an e-cigarette battery caught fire in his pocket at New York City’s Grand Central Terminal filed a lawsuit this week against the manufacturers of the device.

From 2009 to January 2016, the Food and Drug Administration recorded 134 incidents in the U.S. of e-cigarette batteries catching fire, exploding or overheating. The FDA will host a public workshop on safety concerns surrounding the devices next week.

Cancer group renews push to increase tobacco purchase age to 21

Cancer prevention advocates are renewing their push to raise the statewide smoking age from 18 to 21.

The issue has been raised before, as a growing number of cities and towns increase the age for purchasing tobacco. A bill to raise the statewide tobacco purchase age to 21 passed the Senate last year on a vote of 32-2. But the bill never made it through the House.

Carol Clark, a volunteer with the American Cancer Society Cancer Action Network from Gloucester, survived cancer herself. She has two friends currently battling lung cancer caused by smoking. She lost her grandmother to smoking-related emphysema. She plans to come to the Statehouse to lobby for the bill.

“I think kids have too much access (to tobacco),” Clark said. “They start smoking at a young age. It does major damage.”

Clark said she does not understand why so many teenagers start to smoke given the information available today about its health risks. Clark, 61, said she wishes that information was available when her generation and her parents’ generation were growing up.

“I don’t want to see the next generation go through what mine are going through right now,” she said.

According to the American Cancer Society, 95 percent of smokers start smoking before age 21. Supporters of the bill see it as a way to protect children and teenagers and avoid negative public health impacts, including an increase in cancer rates, later on. It would also create uniform rules across the state, as opposed to a patchwork of local ordinances.

Opponents of the bill have argued that 18-year-olds are adults and should be allowed to make their own decisions. And raising the age could negatively affect businesses that sell tobacco.

The penalties for violating the law would be on retailers, not smokers.

Other sections of the bill would ban the sale of tobacco in pharmacies and ban the smoking of e-cigarettes in schools, restaurants and workplaces.

The American Cancer Society Cancer Action Network will be advocating for the bill as part of its annual lobbying day at the Statehouse on Wednesday. The group expects more than 100 people at the event.

The legislation, S.1218/H.2864, is sponsored by Sen. Jason Lewis, D-Winchester, and Rep. Paul McMurtry, D-Dedham. It has approximately 140 co-sponsors.

How Trump Ally Myron Ebell Spread Misinformation for Big Tobacco and Big Oil

The former head of President Trump’s EPA transition team played a central role in the corporate-led attack on public perceptions about tobacco and climate change.

http://www.alternet.org/environment/how-trump-ally-myron-ebell-spread-misinformation-big-tobacco-and-big-oil

“Frontiers will [change] the debate from one about teenage smoking and industry practices to one about massive tax increases, bigger government and loss of individual freedom.” — Frontiers of Freedom funding proposal to Philip Morris

When Phillip Morris didn’t like new FDA regulations that targeted cigarette sales to children and teens, Myron Ebell—who recently served as the head of President Trump’s EPA transition team—was there to “change the debate” to fit the tobacco giant’s agenda.

The FDA’s proposed regulations included prohibiting outdoor advertising of any tobacco products near schools or playgrounds, strictly regulating labeling and prohibiting tobacco company sponsorships of public events. To fight the new restrictions, tobacco-industry-funded Frontiers for Freedom started a campaign to cast doubt on the validity of the new regulations.

Frontiers, a conservative “educational foundation,” hired Ebell as policy director to help run the campaign, even using his name to raise money for the project. In a fundraising letter to Philip Morris in 1998, Frontiers highlighted Ebell as an example of why more funding was needed to run an organized push to make regulating the tobacco industry “politically unpalatable.”

The Frontiers campaign was pure spin. The tobacco companies’ First Amendment rights were being trampled on, it claimed—more Big Government overreach. From pushing the dubious claim that rules infringed on smokers’ and tobacco companies’ rights to blaming smokers themselves, Ebell oversaw Frontier’s tobacco-industry-funded drive to fight regulation. It took a fourteen-year battle for Congress to pass the regulations and make them stick. In the end, the tobacco advertising regulations made significant progress in curbing teen smoking. No thanks to Ebell and Frontiers for Freedom.

In April of 1998, Ebell and a handful of other marketing experts sat around a table with some of the largest U.S. fossil fuel companies to discuss a plan for a similar attack on climate science. Representatives from Exxon, Chevron, utility giant Southern Company and the American Petroleum Institute worked with operatives from established conservative think tanks and public relations wonks to draft a program designed to attack public and political perceptions about climate change. They dubbed it “The Global Climate Science Communications Plan.”

The plan’s strategy was similar to Frontier’s anti-regulation tobacco campaign. This time the goal was to make climate-change-related regulation politically unpalatable.

The foundation of the plan was to sow doubt about the scientific validity of action on climate change, even though in 1998 the science was already solid. Of the ninety-six papers published on global warming that year, just one disagreed about man’s activities driving warming. That truth about the state of the science was replaced with a push to convince “a majority of the American public” that “significant uncertainties exist in climate science.”

The seven-page directive boldly stated that “victory will be achieved when” the uncertainties about climate science are part of “common knowledge,” when media recognizes and covers those uncertainties and when those promoting action on climate science appear out of touch.

Strategies and tactics of the plan included:

• Recruit and train a team of scientists for media outreach
• Produce a steady stream of op-eds written by these scientists
• Organize and teach conservative grassroots groups
• Become a one-stop-shop for members of Congress, state leaders and teachers looking for information about climate change
• Distribute materials directly to schools and convince a national TV journalist to produce a TV program outlining the supposed uncertainties

It worked.

In 2007, television journalist John Stossel did a bang-up job promoting climate confusion with his special, “Myths, Lies and Downright Stupidity,” for a special edition of “20/20.” By 2016, a Pew poll found only 9 percent of conservative Republicans believed that climate research reflects the best available evidence, while 57 percent of that same group felt that climate research is influenced not by valid science, but by scientists’ desire to advance their careers.

In 1999, Ebell moved to Competitive Enterprise Institute, a libertarian think tank funded by many of the same oil companies he’d sat around the table with the year before to hatch the plan to misinform the American public. From 1998 to 2005, ExxonMobil provided CEI with over $2 million dollars of funding. As director of CEI’s Center for Energy and Environment, Ebell put the plan to work.

Impacting the voice of elected officials was another key aspect of “victory” named in the 1998 disinformation plan. By that measure success was swift in coming. Just two years after the plan was hatched, CEI joined with conservative Senator James Inhofe as co-plaintiff in a lawsuit over the National Assessment, a federal report on climate change’s impacts on the United State.

The lawsuit was designed to suppress publication and distribution of recent climate science findings. In 2003, CEI sued the U.S. government directly, demanding the National Assessment not be disseminated. In 2005, Senator Inhofe joined with Ebell and other climate science deniers on a speaker’s panel for a CEI panel to discuss the Future of International and U.S. Climate Policy. By 2012, Ebell was bragging on his blog about Inhofe’s legislation to block EPA regulations. It was a victory: Climate-change-related regulation had become politically unpalatable.

Opposition to the validity of climate science skyrocketed among conservative politicians after 1998. Fighting all government action on global warming is now a bullet point on the GOP’s purity test. Over that same period, oil industry financial support for political campaigns and lobbying efforts have overwhelmingly gone to Republicans.

The election of Donald Trump was icing on the climate science denial cake. Ebell was tapped to head Trump’s EPA transition team. Eighteen years of work deceiving the public finally paid off for Ebell. His dream of drastically reducing the power of the EPA is being realized. Ebell headed Trump’s EPA transition team. He oversaw the writing of a policy paper—not available to the public—that will steer fellow climate science denier and EPA antagonist-turned-EPA head Scott Pruitt. Under Pruitt’s leadership, climate-change-related regulations will be rolled back and the EPA’s budget will be cut by 24percent.

Ebell has no background in science. He studied philosophy and has a master’s degree in political theory. His understanding of modern climate science sounds like this:

The models say that much of the warming will occur in the upper latitudes and in the winter. At the risk of further ridicule in kooky blogs in England, where global warming alarmism is now a religion, that sounds pretty good to me. Fewer people will die from the cold.

Fossil fuel industries got what they wanted. Conservative politicians got what they wanted. CEI got what it wanted. Ebell got what he wanted. All at the expense of the environment, public health and the stability of future generations.

Hope Forpeace is a short film producer with AK Productions. She spoke before the EPA’s Scientific Advisory in 2015 and coordinated the effort to have EPA’s fracking study include known cases of water contamination. She has traveled across the country for several years investigating cases of fracking-related pollution.

California targets candy-flavored tobacco as teen ‘gateway’ to cigarette smoking

More teens are turning to fruit- and candy-flavored tobacco, raising concerns that sweetened e-cigarettes and cigarillos are a gateway to nicotine addiction. A California anti-tobacco campaign targeting teens has ramped up in high schools and at a recent state Capitol rally on Kick Butts Day. Claudia Buck cbuck@sacbee.com

http://www.sacbee.com/news/local/health-and-medicine/article140622513.html

At the checkout counter, the flavors are sweet and enticing: Banana Smash. Twisted Berry. Berry Honey. Cherry Dynamite.

They aren’t in the candy aisle but on the tobacco shelf, often sold in 99-cent two-pack mini-cigars or liquid cartridges for e-cigarettes.

While fewer young Americans are puffing on cigarettes, more teens are using flavored tobacco, typically by vaping with electronic cigarettes or smoking tiny cigars known as cigarillos.

This year, there’s a renewed push to banish flavored tobacco products, which health officials and others fear are luring the next generation of nicotine addicts by targeting teens and kids.

The sweetened flavors are “a gateway to traditional cigarette smoking,” said Scott Gerber, a wellness program director with the Alameda County Office of Education, who attended a recent anti-tobacco state Capitol rally with a handful of high school students from Berkeley and Fremont. Tobacco companies, he said, “are targeting young people with cherry, strawberry, piña colada flavors. … Gummi bears? That’s a youth-friendly flavor, not an adult-friendly flavor.”

Gerber was among about 250 high school students and chaperones who attended the anti-tobacco rally, chanting slogans and carrying signs with messages such as “We want to see a new light, not a lighter” and “We want 7,700 flavors of ice cream, not tobacco!” The rally was part of national Kick Butts Day, co-sponsored by the California Youth Advocacy Network and the Campaign for Tobacco-Free Kids.

In 2014, 73 percent of high school students and 56 percent of middle school students who used tobacco products in the past 30 days reported using a flavored tobacco product, according to the federal Centers for Disease Control and Prevention.

Wheatland High School student Angelina Hom, 15, who belongs to a campus group called SOWHAT (Students Of Wheatland High Against Tobacco), said she’s seen the negative impacts of tobacco firsthand in family members and hopes more of her peers get the message to avoid tobacco.

Convenience stores near her Northern California school have prominent displays of brightly colored, fruity-flavored tobacco products positioned close to the checkout counter, she said. “You go to pay for your food and there’s a wall full of of tobacco and cigarettes. It targets kids into thinking it’s cool.”

E-cigarettes are the most commonly used tobacco product among middle and high school teens in California. An estimated 217,000 Californians between the ages of 12 and 17 currently smoke traditional cigarettes or e-cigarettes, according to state health officials.

In stores, although tobacco products by law must be behind glass, it’s not unusual to find Swisher Sweets, candy-flavored cigarillos sold in two-packs for less than a dollar, sitting near candy bars and snacks, at eye level of young customers.

“Having it advertised as candy unlocks the door to the world of addiction,” said shopper Jenni Richardson, 24, in a midtown Sacramento convenience store where Swisher Sweets sit directly above the ice cream freezer case. A self-described recovering heroin addict, Richardson said tobacco products are dangerously addictive, noting it was far easier for her to quit narcotics than nicotine.

Last summer, the growth in e-cigarette use helped prompt California to toughen state tobacco laws, raising the minimum age for legally buying cigarettes and cigars from 18 to 21, the first change since tobacco control laws went into effect 144 years ago. Also for the first time, those laws now apply to e-cigarettes, which have become hugely popular for their myriad fruit and candy-scented flavors, with names such as Watermelon Krush, Apple Pie a la Mode and Blueberry Cotton Candy.

Some counties have banned all sales of flavored tobacco, including Yolo County, which prohibits sales in the county’s unincorporated areas, starting May 1. The intent was to deter use by youths, said Keri Hess, the county’s tobacco prevention youth coordinator.

“Lots of kids who use e-cigarettes would never dream of trying a regular cigarette because they say it tastes gross. They know the hazards of regular cigarettes and tobacco, but they don’t recognize the health hazards of e-cigarettes,” Hess said.

In Yolo County, 73 percent of stores carried e-cigarettes last year compared with 46 percent in 2013.

The state’s crackdown came as illegal sales of tobacco to minors were up last year by more than a third from 2015, according to the state Department of Public Health’s annual survey, which took place before the legal age was changed. Using teenage decoys trying to buy smokes, the annual survey found that 10.3 percent of 793 stores sold tobacco to underage buyers, the highest rate in eight years.

Citing research that shows brain development continues until around age 25, state health officials say nicotine is a “highly addictive neurotoxin” that can permanently damage adolescent and young adult brains.

“The younger people are when they start smoking or using nicotine, the more likely they are to become addicted,” said State Public Health Officer Dr. Karen Smith during a news conference last summer. Every year in California, she noted, 34,000 people die of tobacco-related diseases.

She said the surge of teens vaping with e-cigarettes is no accident, given the “aggressive marketing” and the proliferation of gadgets and flavors by tobacco companies. Calling them “enticing gateway products,” Smith said e-cigarettes are “fueling the addiction” to nicotine.

Since 2009, the U.S. Food and Drug Administration has banned the sale of cigarettes with fruit and candy flavors, part of federal efforts to reduce tobacco addiction among youths. More recently, the FDA is focusing on cigars and cigarillos (mini-cigars). In December, it issued warning letters to four tobacco companies, including Swisher International Inc., maker of Swisher Sweets, for selling cigars in “youth-appealing” flavors, such as grape, wild cherry and strawberry.

If the companies don’t take action, they could face civil penalties, criminal prosecution and seizure of products, according to the FDA.

“Flavored cigarettes appeal to kids and disguise the bad taste of tobacco, but they are just as addictive as regular tobacco products and have the same harmful health effects,” said Mitch Zeller, director of the FDA’s Center for Tobacco Products, in a statement. He said continued bans on flavored tobacco are essential to “protect future generations from a lifetime of addiction.”

To students at the recent state Capitol rally, the brightly colored packaging and sweetened flavors are “like candy,” enticing teens and kids to get hooked on nicotine at an early age, said Naphatsorn Kaewwanna, 18, a high school senior with the Asian American Drug Abuse Program in Los Angeles County.

“We should put a stop to it,” she said.

 

Cancer Activists Push Bill to Hike Legal Age to Buy Tobacco

Over 100 cancer patients, survivors and their families from across Massachusetts are planning to gather at the Statehouse to press lawmakers to support efforts to protect young people from nicotine addiction.

http://www.capecod.com/newscenter/cancer-activists-push-bill-to-hike-legal-age-to-buy-tobacco/

At the top of the agenda is a bill that would increase the legal age to buy tobacco products from 18 to 21.

The legislation would also include e-cigarettes in the smoke-free workplace law and ban the sale of tobacco products in facilities that provide health care, such as pharmacies.

About 95 percent of adults who smoke started by age 21.

More than 140 communities in the Commonwealth have passed regulations raising the purchase age from 18 to 21, including Falmouth, Mashpee, Yarmouth, Brewster, Orleans, Eastham and Provincetown.

The Board of Health in Harwich will hold a public hearing April 11 to discuss a proposed regulation change to increase the legal age to 21. The board could vote on the measure that night.

Wednesday’s visit to Beacon Hill is part of the American Cancer Society Cancer Action Network’s annual lobby day.

This year, an estimated 37,000 Massachusetts residents will be diagnosed with cancer. An estimated 12,600 will die from the disease.

Guam raises tobacco age to 21 come 2018

The legal smoking age in Guam will be 21 next year.

http://www.dailymail.co.uk/wires/ap/article-4346104/Guam-raises-tobacco-age-21-come-2018.html

The Pacific Daily News reports (http://bit.ly/2nPFaIb ) that a measure lapsed into law this week raising the legal age to use or purchase tobacco products from 18 to 21 stating Jan. 1, 2018. Lawmakers unanimously passed the measure on March 9 and the governor took no action, meaning the measure automatically became law.

Last year, the Legislature passed a similar bill to raise the legal tobacco age to 21 but Gov. Eddie Calvo vetoed it, saying the bill didn’t give residents the freedom to choose.

According to the American Cancer Society, smoking rates on Guam have declined in recent years to 27.4 percent, but still remain higher than the national average of 17.5 percent.

Oregon Senate approves raising the tobacco use age to 21

The state Senate has approved raising Oregon’s minimum age for tobacco use to 21.

http://ktvl.com/news/local/oregon-senate-approves-raising-the-tobacco-use-age-to-21

The bill approved 19-8 on Thursday now heads to the House. If the proposal is eventually signed by Gov. Kate Brown, Oregon would be the third state to increase the legal age for buying and possessing cigarettes and other tobacco products from 18 to 21.

Hawaii was the first state to increase the age, followed by California. Dozens of cities and local jurisdictions have adopted the policy over the years, including Oregon’s Lane County.

The proposal would reduce Oregon’s tax revenue from tobacco by $1.76 million in the upcoming two-year budget, adding slightly to the state’s projected $1.6 billion budget shortfall.

The losses, however, could be covered from proposals to increase tax rates on tobacco.

Guam raises tobacco age to 21 come 2018

The legal smoking age in Guam will be 21 next year.

http://www.dailyprogress.com/guam-raises-tobacco-age-to-come/article_29ad8ba9-8df0-5ec5-8df2-51f052eee133.html

A measure lapsed into law this week raising the legal age to use or purchase tobacco products from 18 to 21 stating Jan. 1, 2018, The Pacific Daily News reported (http://bit.ly/2nPFaIb ). Lawmakers unanimously passed the measure March 9 and the governor took no action, meaning the measure automatically became law.

Last year, the Legislature passed a similar bill to raise the legal tobacco age to 21 but Gov. Eddie Calvo vetoed it, saying was a “willful intrusion into the personal lives and choices of our citizens.”

Adelup Director of Communications Oyaol Ngirairikl said Calvo maintains his stance that residents should be free to choose, but acknowledges that the majority of senators voted in favor of the smoking-age measure, making it immune to a veto.

“Guam’s youth smoking rate is the highest in the nation,” said Speaker Benjamin Cruz on Thursday. “And at a time when tobacco kills more people than alcohol, car accidents and illicit drugs combined, how then can we ignore the fact that doing nothing would not only have protected Big Tobacco, but condemned future generations of young people to disease and death?”

According to the American Cancer Society, smoking rates on Guam have declined in recent years to 27.4 percent, but still remain higher than the national average of 17.5 percent.

Health care officials who supported the measure to raise the smoking age cited a March 2015 Institute of Medicine report that projected tobacco use in the nation to drop by 12 percent if the legal smoking age was raised to 21.