Advocates say the new law will decrease significantly the number of people who start smoking. According to the Centers for Disease Control and Prevention, 9 out of 10 smokers tried it for the first time by the age of 18. Furthermore, 21-year-olds are less likely than 18-year-olds to pick up a cigarette in the first place.
“That's really what it's about, is building in that social distance between 18 and 21,” said Shelby Massey, the American Heart Association's government relations director for Texas. “It's very rare for a 30-year-old to take up smoking.”
Under the age of 21, the brain is still developing and is particularly susceptible to the addictive properties of nicotine and the toxins from cigarettes and e-cigarettes. Members of that age group are also the most likely to experiment and try new things. Once you're hooked on the nicotine, it's much harder to quit, said Dr. David Balis, who runs the smoking cessation program at UT Southwestern Medical Center and Parkland Hospital.
“If no one started before the age of 21, I think that generation would have a whole lot less smokers,” he said.
Texas is one of 18 states to pass such a law and the 11th to implement it, joining Arkansas and Vermont in making the change on Sept. 1. Three more states, New York, Maryland and Connecticut, will follow suit later this year, and Washington and Utah have passed laws that will take effect in 2020 and 2021, respectively. Hawaii, California, New Jersey, Oregon, Maine, Massachusetts, Illinois, Virginia, Delaware and Ohio already have similar laws in place.
Balis hopes the new laws will help continue the downward trend of smokers in the United States. Since the surgeon general's first warning in 1964 about the health issues associated with smoking, the number of smokers in the country has decreased 42%, down to 14% in 2017. Balis hopes that number will be 0 someday.
According to the Texas State Department of Health, 16% of middle school and high school students have smoked at least one cigarette. According to statistics from the Campaign for Tobacco-Free Kids, 11.3% of Texas high school students smoke cigarettes, and 18.9% use e-cigarettes. Those numbers do not indicate how many students use both.
“This is real prevention with no cost or downside. It's all good." — Dr. David Balis
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Although there is not enough research to indicate exactly how dangerous e-cigarettes are, Balis is concerned about the rise of e-cigarette use among teenagers, because he sees them as a gateway to cigarettes. In the last two months, a serious lung illness closely linked to vaping has sickened nearly 200 people and is most likely responsible for one death.
Smoking is associated with a variety of medical issues, including cancer, emphysema and heart disease. Both Balis and Massey listed smoking as the No. 1 preventable cause of premature death.
As for what this means for 18-, 19- and 20-year-olds who currently smoke, that's not immediately clear. The law makes an exception for active military members but does not mention private citizens who smoke in that age bracket.
Balis hopes it will encourage them to stop smoking.
“This is real prevention with no cost or downside. It's all good,” he said of the new law.
The fine for underage purchase of cigarettes, e-cigarettes or tobacco products is $100. Businesses caught selling these products to underage recipients can be fined up to $500. The Dallas Police Department did not respond to requests for comment about how they plan to enforce the measure.
