McConnell bill to raise tobacco age to 21 passes first hurdle, without controversial provision requiring states to follow suit

This story has been updated to correct an error.

By Melissa Patrick
Kentucky Health News

U.S. Senate Majority Leader Mitch McConnell’s bill to raise from 18 to 21 the nationwide minimum age to buy all tobacco products, including electronic cigarettes, has passed the Senate health committee, with a compromise removing the original requirement for states to pass their own “Tobacco-21” laws.

“I’m grateful to my colleagues for advancing our legislation to help curb the spike of youth tobacco use,” McConnell said in a news release. “Because children are extremely vulnerable to becoming addicted to nicotine and suffering its lifelong consequences, we must do everything we can to keep these products out of their hands.”

The bill is co-sponsored by U.S. Sen. Tim Kaine, a Democrat from Virginia.

In Kentucky, about one in four 10th and 12th graders and one in seven eighth graders vaped in 2018, according to the 2018 Kentucky Incentives for Prevention Survey.

The bill is now part of a 246-page amendment to the proposed Lower Health Care Costs Act of 2019, which includes legislation on a long list of health topics, including ending surprise medical bills, reducing the prices of prescription drugs, improving transparency in health care, improving public health, and improving the exchange of health information.

The Campaign for Tobacco-Free Kids opposed the original version of the bill, which included state law requirements, but supports the bill with the compromise legislation included.

“This compromise legislation raises the tobacco age to 21 nationwide and provides incentives and support for states to conduct enforcement, but it does not require that states pass laws that tobacco companies could use to block local tobacco regulations, including much-needed prohibitions on flavored tobacco products that entice and addict kids,” the organization said in a June 25 news release.

The campaign added, “As this legislation moves forward, we urge Congress to maintain this important change and ensure the Tobacco 21 provisions are not weakened.”

The concern about the original provision to require each state to pass its own Tobacco-21 law was that it put federal substance abuse block grants at risk if states didn’t do so. Further, opponents of this provision worried that it would weaken state and local efforts by providing an opportunity for the tobacco industry to add special-interest provisions to state laws.

The tobacco industry, which is moving into electronic cigarettes, has supported a higher legal age to purchase tobacco products as a way to reduce pressure for youth-oriented regulations.

As of June 20, 16 states had already raised the tobacco age to 21, along with Washington, D.C., and at least 470 localities, according to the Campaign for Tobacco-Free Kids. It notes that the strength of each law “varies substantially.”

Such a bill was introduced in Kentucky during the last legislative session, but failed to get out of the Senate Agriculture Committee.

An editorial in The Winchester Sun applauds the concept of raising the legal age, but adds that McConnell’s bill doesn’t do enough, and suggest that this piece of legislation should simply be an “opening bid.”

“Public outcry over companies making money by selling flavored addiction juice to kids has forced those companies and their supporters to the table,” the editorial says. “National T-21 legislation is their dream scenario. The legal age to buy e-cigarette products is already 18, so the law extends that prohibition by three years. In exchange for those three years, they want to be free to make their products as addictive and enticing as possible, including in ways that might appeal to minors.”

The McConnell press release provided a list of nearly 60 organizations that support his bill, 10 from Kentucky: the Foundation for a Healthy Kentucky; the Kentucky Chamber of Commerce; the Kentucky Hospital Association; the Kentucky Medical Association; Kentucky Youth Advocates; the Kentucky Academy of Child and Adolescent Psychiatry; CHI Saint Joseph Health; the Kentucky Chapter of the American College of Cardiology; St. Elizabeth’s Healthcare in Northern Kentucky; and Hosparus Health. 

The foundation, KYA and Kentucky Voices for Health published an op-ed endorsing the bill, along with the Kentucky School Boards Association, the Kentucky Cancer Foundation, the American Heart Association, the American Lung Association, the American Cancer Society Cancer Action Network, the Drug Free Clubs of America, the Northern Kentucky Chamber of Commerce and the Children’s Home of Northern Kentucky Behavioral Health. 

Even though “tobacco-21 laws directly affect those who are 18 to 20 years old, the largest proportionate reduction in the initiation of tobacco use will be among adolescents ages 15 to 17,” the op-ed says, citing a March 2015 report from the Institute of Medicine. The report concluded that “raising the national age to 21 would immediately improve adolescent health, decrease smoking by 12 percent nationwide and prevent hundreds of thousands of premature deaths.”

The op-ed adds, “A key reason tobacco-21 works is that most youth get tobacco products from friends and family members, rather than purchasing the products themselves. It’s much more common for adolescents and teens to hang out with those who are at or near their own age, than to have friends who are 21 or older. Thus, raising the legal sale age for tobacco products to 21 cuts off a major social source of tobacco for adolescents and teens.”