On Monday, Senate Majority Leader Mitch McConnell introduced legislation to raise the tobacco-purchasing age to 21, in an effort to counter the recent spike in e-cigarette use among teenagers that threatens the decades-long decline of youth smoking rates. Joined by Virginia senator Tim Kaine as a co-sponsor, the bill enters the Senate with a bipartisan endorsement from representatives of two top tobacco-producing states. Rarer still than this aisle-crossing effort that counters local titans of agribusiness, is the possibility that a GOP leader has put forth a bill that may benefit public health.
The bill would raise the purchasing age for all tobacco products, though e-cigarettes are the intended focus, considering the low rates of actual cigarette use among teenagers. In 2018, around two in 25 high-school students reported that they smoked a rolled cigarette in the past month, per the CDC. But in that same year, one in five high-schoolers said they had vaped in the past month. That number is growing rapidly: According to the CDC, e-cigarette use among high-schoolers jumped 78 percent between 2017 and 2018.
The bill does not prevent state and local governments from passing more stringent laws regarding tobacco use. Unlike McConnell’s original draft, military personnel under the age of 21 would not be exempt. Though the full effects of e-cigarette use — aside from nicotine addiction — are not yet fully known, the link between teenage use and a lifetime habit is well established: According to the CDC, 90 percent of tobacco users will try their first cigarette before they turn 18.
An April draft of McConnell’s bill drew the suspicious combo of industry enthusiasm and health-advocate skepticism. “They are turning these Tobacco 21 bills into Trojan horses,” John Schachter, director of state communications for the Campaign for Tobacco-Free Kids, told Politico in April. “Tobacco 21 needs to be a complement” to other measures, Schachter said, including crucial increases in state taxes proved to deter smoking. (A 10 percent increase in the real price of cigarettes reduces adult smoking rates by around 2 percent.)
On Monday, anti-smoking advocates generally responded positively to the bill — with the caveat that it’s one of many steps on the road to cutting smoking rates in the U.S. “Raising the minimum age of sale to 21 is one of the important policies the American Lung Association has called on Congress to pass in the 116th Congress,” ALA president Harold Wimmer said in response to the bill. Wimmer also cited “restricting online sales of tobacco products and increasing funding for the Centers for Disease Control and Prevention’s (CDC’s) Office on Smoking and Health” as pivotal actions moving forward.
McConnell’s anti-smoking bill is a clear departure from standard Republican procedure regarding public health. Consider just a few policy proposals from Republicans during the Trump administration: revoking abortion access in Alabama, Georgia, and Florida, which may lead to higher rates of self-induced procedures; keeping unnecessary coal plants on the market, leading to the premature deaths of 1,400 Americans every year; an attempt to delay new lead-paint rules, which was denied by a federal appeals court; numerous attempts to repeal the popular Affordable Care Act with no viable alternative in its stead; Trump’s decision to declare an emergency on opioids with very little follow-through; and a proposed federal budget cut to international AIDS funding that would result in the deaths of over 1 million people living with HIV.
In this context, Senator McConnell’s pursuit of anti-smoking legislation seems against the grain of GOP practice, not to mention the party’s larger qualms regarding government intrusion on personal choice. Then again, the GOP has always been fine with regulating private issues it has deemed to be immoral or uncouth.