In less than two years, California's Tobacco 21, or "T21," law has proved to be a powerful weapon in the war on illegal tobacco sales to underage youth. Signed into law by Governor Edmund G. Brown Jr. in 2016, Tobacco 21 prohibits tobacco retailers from selling tobacco products, including e-cigarettes, to anyone under 21. Research now shows that illegal tobacco sales to underage youth have dropped almost in half, down to 5.7 percent in 2017 from 10.3 percent in 2016.
This news is a welcome breath of fresh air to the California Department of Public Health. The department had just 45 days to enact a massive outreach campaign, and now more than 98 percent of tobacco retail store owners, managers, and clerks are aware of the T21 law. Happily, the majority of them support it. Conversely, it's disappointing to note it's the "tobacco only" stores that still have the highest rate of illegal tobacco sales to minors.
California was the second state in the nation, after Hawaii, to enact such a statewide law and since then a handful more have followed suit. Stopping the illegal sale of tobacco products and e-cigarettes to underage youth is, indeed, a national issue but it's not without opposition. Tobacco companies constantly bombard teens with thick-as-smoke persuasive advertising. The flashy tobacco marketing tools used by Big Tobacco infer smoking is a way for teens to fit into social groups and feel "normal" in an often chaotic time of life. One underage community specifically being targeted by Big Tobacco is LGBTQI youth.
According to the Centers for Disease Control and Prevention, high rates of tobacco use among LGBTQI youth is due in part to the aggressive marketing by tobacco companies that sponsor events, bar promotions, giveaways, and advertisements. Using the guise of community support, tobacco companies financially support gay Pride festivals and other LGBTQI community events and contribute to local and national LGBTQI and HIV/AIDS organizations. Evidence indicates LGBTQI adolescents are especially susceptible to tobacco use. According to LGBT Healthlink, tobacco use is the most serious, yet, preventable health crisis facing lesbian, gay, bisexual, and transgender youth in their teens and 20s. Approximately 40 percent of LGBTQI high school students actively use at least one type of tobacco product, a rate that's 33 percent higher than among heterosexual students. LGBTQI youth are also twice as likely to be daily smokers and they have higher rates of tobacco-related health issues throughout their lifetime.
The Tobacco 21 law can't make the insistent Big Tobacco marketing any less appealing, but it does make it much harder for young people to get their hands on tobacco products. The age limit reduces peer-to-peer access to products because teens under 18 are less likely to socialize with 21-year-olds than with 18-year-olds.
California's T21 law is a crucial step toward eradicating illegal tobacco product sales to underage youth. However, tobacco use of any kind is a formidable foe that isn't wafting away any time soon. The health risks of smoking cannot be overstated, yet despite having one of the lowest percent of smokers in the nation, 3.2 million Californians continue to smoke cigarettes. Most smokers want to quit, and about 60 percent of smokers try to quit each year, but the rate of quitting attempts has not increased much in decades. Many smokers try to quit without any help, which means that they are not using evidence-based treatments, such as cessation counseling and nicotine replacement therapy.
For anyone of any age wanting to quit smoking, CDPH recommends visiting the California Tobacco Control Program website, or visit the Helpline at www.nobutts.org.
April Roeseler, BSN, MSPH, is chief of the California Tobacco Control Program at the California Department of Public Health.