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City Council Testimony

On Feb. 8, 2016, I represented the Chicago Medical Society before the City Council Finance Committee. We were there to testify in support of a reform package that is long overdue—raising the legal age to buy tobacco products, including e-cigarettes, cigarettes and smokeless tobacco, to 21. Short of banning these products altogether, raising the purchase age and slapping on taxes are our next best strategies to protect teenagers. Research shows that both strategies work.

Mayor Rahm Emanuel’s proposed package also would regulate the price and quantity by which select tobacco products are sold.

We are pleased that these reforms align closely with the policy positions already taken by the Chicago Medical Society. CMS adopted policy in 2014 as a result of a resolution to raise the purchase from 18 to 21. Last fall (October 2015), CMS gave its unqualified support to extending the tax on cigarettes to smokeless tobacco and electronic cigarettes. CMS further passed a directive to pursue legislation in the Chicago City Council.

On a less positive note, there was some testimony at City Hall against the proposal. Some aldermen are more concerned about the economic impact on gas stations and convenience stores—rather than the health and well-being of their constituents. The CMS testimony highlighted data from the Centers for Disease Control, reporting the cost of smoking each year in the United States. The total economic cost is more than $300 billion a year, including nearly $170 billion in direct medical care for adults. More than $156 billion is lost productivity due to premature death and exposure to secondhand smoke.

We know from research that nearly 90% of adults who smoke on a daily basis had their first cigarette by age 18; and that 90% of cigarettes purchased for use by those under age 18 are purchased by those aged 18-20.

Tobacco companies have admitted in their own internal documents that, if they don’t capture new users by their early 20s, it is very unlikely that they ever will. In 1982, one RJ Reynolds researcher stated: “If a man has never smoked by age 18, the odds are three-to-one he never will. By age 24, the odds are 20 to 1.”

Organizations like the Institute of Medicine has emphasized that increasing the legal age to buy tobacco products will likely prevent or delay initiation of their use by adolescents and young adults.

We are optimistic that the proposed ordinance will pass. Numerous cities and states have raised the purchase age to 21. Last summer, Hawaii became the first state to raise the tobacco sale age to 21. At least 115 localities in nine states, including New York City, Boston, Cleveland and both Kansas Cities, have also raised the tobacco sale age to 21. Statewide legislation to do so is being considered in several states, including California.

The enactment of laws at the city, county and state levels, as well as higher taxes and educational campaigns, have all led to an overall decline in smoking rates. We must continue this progress.

Adrienne L Fregia  MD
Board of Trustees

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