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ECU, UNC study shows strong support for raising age to purchase tobacco products

There is strong support in all regions of the United States for raising the legal age of tobacco sales, according to a national survey conducted by researchers from East Carolina University and the University of North Carolina at Chapel Hill.

The study results, recently reported in the American Journal of Preventive Medicine, show a majority of adults support increasing the minimum legal age for tobacco product sales, and most support increasing the minimum age to 21.

“With these findings, policy makers and public health advocates can move forward knowing that people in their states support raising the minimum legal age for selling tobacco products, and that this is an issue that is not viewed as partisan,” said Adam O.

Goldstein, a UNC Lineberger Comprehensive Cancer Center doctor and member and a professor in the UNC School of Medicine Department of Family Medicine. “It seems to cross political lines, and it is one policy measure that the majority of those surveyed can agree on.”

Pitt County once was the nation’s largest producer of flue-cured tobacco, the major component of mass-produced cigarettes.

Candidates running for state House District 9, which encompasses eastern Pitt County, said they support increasing the legal age for tobacco product sales to 21.

“I don’t know that North Carolina is necessarily ready to take it up, but it’s an issue that needs to be taken up,” said Greenville urologist Greg Murphy, the district’s Republican representative.

“We are paying millions and millions in health care dollars because of the effects of tobacco use, and 90 percent of lifelong smokers start before the age of 18.”

The Campaign for Tobacco-Free Kids found that each day more than 2,500 children in the United State try their first cigarettes with another 580 becoming new daily smokers.

Murphy said that while there isn’t enough time to take up such legislation in the current short session, he thinks there should be discussions.

“I don’t want to be seen as governmental overreach, me telling everybody what to do, but when those particular actions affect other parts of our society, especially with health concerns, as not only a physician but as a legislator, I think it’s reasonable to have input,” Murphy said.

Brian Farkas, the Democrat running for the House 9 seat, said since eastern North Carolina’s history is tied to tobacco, a representative from the region should be a part of any changes in tobacco sales regulations.

“I think there’s one thing we need to be talking about in field of medicine, and that is preventative care,” Farkas said.

“Based on the data I am seeing and the report … there is potentially large savings and public health impacts by bumping it up three years, while there would be relatively minimal cost to tobacco sales.”

The joint study comes as two states recently have moved to increase the legal age of tobacco sales to 21. Hawaii became the first U.S. state to make the change on Jan. 1, and California followed suit earlier this year. Already, a number of counties and cities, including New York City, have increased the minimum legal age.

“With the strong support indicated in our data, I think we will continue to see strong momentum,” Goldstein said. “It appears likely that increasingly, lawmakers are going to be interested in doing this.”

According to a National Academy of Medicine report in 2015, increasing the legal age for purchasing tobacco products likely would lower health care costs and would prevent or delay young adults from starting smoking. The U.S. Food and Drug Administration-sponsored report predicted that raising the legal age to 21 nationally would
result in a 12-percent reduction in smoking prevalence.

“By restricting tobacco use to people 21 and older, the compelling evidence is that you have less people who end up using it. They don’t end up taking up smoking and tobacco,” Goldstein said. “And if you cut down on adolescents using tobacco, you’ll ultimately cut down on how many adults use tobacco, and then you cut down on tobacco related diseases like heart disease and cancer.”

In the study, researchers surveyed 4,880 adults ages 18 or older to learn their views on raising the minimum age of tobacco sales to 19, 20 or 21. The telephone survey was offered in both English and Spanish and conducted on landline and cellphones.

A majority of people surveyed supported raising the minimum age in all regions of the country. Levels of support ranged from 59.6 percent in a seven-state Midwestern region to 73.1 percent of residents in a four-state region of the South that included Texas and Louisiana. In the South Atlantic region, which included North Carolina, 68.1
percent of people supported an increase.

“Even in regions with historically strong ties to tobacco growing and manufacturing, a strong majority of the public, including smokers, is in favor of raising the minimum legal age of tobacco sales,” said the study’s first author Joseph G.L. Lee, an assistant professor at the ECU College of Health and Human Performance. Lee began the study as a doctoral student at the UNC Gillings School of Global Public Health.

Women, non-white adults, Latinos and non-smokers were more supportive of an increase, as were those who were older than 21.

“What we found was really an overall trend of broad support for this policy,” Goldstein said.

Hayes Hutchens, an employee of Blackbeard Cigars, which sells premium cigars and pipe tobacco, has mixed feelings about raising the legal age of tobacco sales.

“The catching point would be alcohol, tobacco, anything like that, you’re old enough to serve in the military but not old enough to make a decision about your vices?

However, my daughter just turned 21 and I wouldn’t have wanted her to use either one of them before then,” Hutchens said. Even though she’s older, Hutchens said he still doesn’t want his daughter to use tobacco.

“I wouldn’t have a problem with a 21-year-old (age limit),” he said.

Blackbeard Cigars gets the occasional college student to come in, Hutchens said.

“They tend to be more seasonal, at the beginning of the semester, around the holidays, around graduation, but they aren’t a regular customer base,” he said.

The study was supported by grants from the National Institutes of Health, National Cancer Institute and the FDA Center for Tobacco Products.

In addition to Goldstein and Lee, the study was co-authored by Marcella H. Boynton and Amanda Richardson of the UNC Gillings School of Global Public Health Department of Health Behavior and Kristen Jarman and Leah M. Ranney of the UNC School of Medicine Department of Family Medicine.

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