One of the most memorable—and, frankly, frightening—anti-smoking ad campaigns came out on TV in 2012 and featured a woman named Terri. She had a hole in her throat from losing her larynx to oral and throat cancer. "I'm Terri, and I used to be a smoker," she says in the 30-second, CDC-sponsored commercial, her voice gravelly from the artificial voice box. "I want to give you some tips about getting ready in the morning. First your teeth. Then your wig. Then your hands-free device. Now you're ready for the day."
This YouTube video of Terri, who died in 2013 after her long battle with cancer, has garnered almost 6 million views to date.
To address the harm associated with smoking, advocates have focused their energy on policy changes, such as increasing funding for state prevention and cessation programs, to help reduce tobacco use. But in recent years, organizations like the Campaign for Tobacco-free Kids and Tobacco 21 have turned their attention to raising the minimum age to buy tobacco products from 18 to 21. So far, five states–Hawaii, California, New Jersey, Maine, and Oregon–and more than 260 cities and towns have passed these laws, known as Tobacco 21 laws, banning the sale of cigarettes to anyone under 21.
Researchers suggest that if young people can make it to the age of 21 without using, they're more likely to remain tobacco-free.
Chris Sherwin is the vice president for state advocacy for Campaign for Tobacco-free Kids. He's been personally involved in tobacco prevention work since the mid-90s partly because of a family connection: His stepfather smoked four packs of cigarettes a day and ultimately died of a heart attack. Their goal, he told VICE Impact, is to deter teenagers and young adults from ever starting to smoke.
According to the CDC, nearly nine out of 10 cigarette smokers first tried it by age 18, and researchers suggest that if young people can make it to the age of 21 without using, they're more likely to remain tobacco-free.
Raising the minimum age to buy tobacco products eliminates an important source for high schoolers: Their 18-year-old friends who are still in school.
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"The rationale here is you remove that source of tobacco within the school setting, and the friend-to-friend setting, thus making tobacco more difficult for teenagers to get," Sherwin said.
According to a 2015 report from the Institute of Medicine, the age group that will be most impacted will be 15- to 17-year-olds. "Overall," the authors note, "in the absence of transformative changes in the tobacco market, social norms and attitudes, or in the knowledge of patterns and causes of tobacco use, the committee is reasonably confident that raising the MLA will reduce tobacco use initiation, particularly among adolescents 15 to 17 years of age; improve the health of Americans across the lifespan; and save lives."
Another important factor, Sherwin adds, is that "nicotine has a particularly potent effect on the developing brain." In short, nicotine use is going to have a different effect on someone who's 16 than someone who's in their late 20s. According to research, It's going to actually give them a great chance of addiction
Of course, not everyone agrees that teenagers shouldn't be allowed to purchase cigarettes from their neighborhood corner store. For example, last month, Maine Gov. Paul LaPage vetoed a measure that brought the legal age to purchase tobacco to 21; lawmakers, however, overrode his veto. The Republican governor was pissed.
"This law subverts the United States Constitution and attempts to 'social engineer' legal behavior by adults who want to use a legal product that you don't like," LePage wrote to lawmakers, calling them "hypocrites." "If you don't believe 18-year-olds are adults who can make their own decisions, then I hope you will support legislation that increases the voting age to 21 and prevents military service until a person turns 21."
Despite his odd response—the Constitution plainly states that the right of vote be guaranteed to people 18 and up—LaPage raised an interesting point. What about individual freedoms?
"To equate tobacco addiction, a lifelong addiction to a deadly product, with freedom, we think is completely wrong," Sherwin noted. "This actually becomes a source of not being free and chained to an addition that will likely kill them."
Considering tobacco use is the leading cause of preventable death in the US — by 2030, more than 8 million people will die annually from causes related to smoking—it's important that something be done to change this trajectory.
"To equate tobacco addiction, a lifelong addiction to a deadly product, with freedom, we think is completely wrong."
In 2015, a Tobacco 21 bill was introduced in the US Senate, but didn't get anywhere. Regardless, it garnered the support of a number of health groups, including the American Cancer Society Cancer Action Network, the American Heart Association, the American Lung Association and the American Academy of Pediatrics.
If you're interested in joining the movement to raise the tobacco purchase age to 21, check out this advocates' toolkit from Tobacco21.org to get started in your local community.