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Mizzou county joins trend of higher 'smoking age'

St. Louis County in eastern Missouri on Sept. 6 banned sales of all tobacco products to anyone under the age of 21. It is the latest in a nationwide effort to ban such sales, even if it means doing it one city or county at a time.  
Tobacco 21, a non-profit organization dedicated to increasing the minimum age to 21 to purchase tobacco products nationwide, said St. Louis County became the 191st local government entity in the country to impose such a law, which goes into effect on Dec. 1.
 
Hawaii became the first state to pass a statewide Tobacco 21 (T21) law in June 2015. On May 4, 2016, California became the second.
 
Rob Crane, M.D., president of Tobacco 21, said his movement decided to focus on individual cities and counties with the hopes of eventually getting all states and the nation to increase the minimum age.
 
“Because of the lobbying power of the tobacco industry, it is very difficult to get it passed in state legislatures,” Crane said. “So our strategy is to get it passed city-by-city. One-third of the population in Missouri now is covered by the ban.”
 
Crane said an increase in the age for tobacco purchases falls in line with other items designated as illegal for anyone under 21 to purchase.
 
“The minimum age to purchase alcohol, hand guns and marijuana in states that have legalized it is 21 so it makes sense to raise the age for tobacco products,” Crane said. “Tobacco is the most dangerous substance on the face of the earth, killing 500,000 Americans a year. It’s a public health issue.”
 
Two proposals (Senate Bill 2100 and House Bill 3656) to raise the age nationwide were introduced in Congress in 2015, but neither gained traction.
 
“The lobbying power is too strong to get something passed on the federal level,” Crane said. “It has to be the states to move the initiative forward. When the smoke-free movement began several years ago, to ban smoking in public places, we saw an amazing cultural change. I think that’s what is happening now with younger people smoking. Most people recognize that we don’t want our kids addicted to tobacco because it changes their brains.”
 
St. Louis County, which encompasses 90 individual municipalities and 10 designated unincorporated areas, became the seventh local government in Missouri to increase the age. Columbia, Mo., became the first city in Missouri to pass a local ordinance in December 2014. Kansas City passed an ordinance in November 2015.
 
In a March 17, 2015, KBIA, Mid-Missouri Public Radio, article (http://kbia.org/post/columbias-tobacco-21-ordinance-working), observers said the Columbia ordinance had little impact because people are willing to drive a short distance outside of city limits to purchase tobacco products. The law prohibits the sale of tobacco but does not prohibit anyone under the age of 21 from using the products.
 
The St. Louis County ban encompasses the sale of all tobacco products, including e-cigarettes (also known as vaping), which the U.S. Food and Drug Administration classifies as tobacco products. Just like Columbia, it does not ban anyone under the age of 21 from using the products.
 
The St. Louis County Council passed the ordinance with a 5-1 vote. Republican Mark Harder cast the lone dissenting vote.
 
“I’m against cigarettes and smoking but as I dug into the bill, it was more about liberty issues and consistency with our current laws,” Harder said. “It’s already illegal for anyone under 18. You can die for your country, sign a contract, buy a house, vote and die in the electric chair at the age of 18.”
 
Harder said he also was concerned about enforcement.
 
“Just because anyone under 18 can’t purchase tobacco products doesn’t mean they can’t get access to them,” Harder said. “There’s no enforcement now. No police officer is going to give a 16-year-old a ticket or lock them up. The only penalty is for the retailers. The health department is supposed to police the sale of tobacco products on the retail side. I asked our director of the health department, who has been here for two years, how many tickets had been issued for violations. He said maybe two to three. I asked how many people were cited for being in possession of tobacco under the age of 18. He said none.”
 
Additionally, Harder said that anyone under the age of 21 still can obtain tobacco products simply by driving to neighboring counties.
 
“It will be easy for someone to drive an extra mile or two to another county and come back with a bunch of cigarettes,” he said.
 
Still, Harder said he expects to see neighboring counties consider the legislation, including the City of St. Louis, St. Louis County’s neighbor to the east.
 
“(Tobacco 21) is trying to go after the big fish and create a ripple effect,” Harder said. “Their agenda is to go county-by-county and city-by-city until it gets to the point of critical mass and the state eventually imposes it. In St. Louis County, there are 90 municipalities who now do not have a say in the matter for their own cities. (Advocates) are trying to go to the highest governing authority, and that’s the county’s health department.”
 
Francis Slay, mayor of the City of St. Louis, has said he would support the Tobacco 21 legislation in the city. On Sept. 7, he tweeted to his followers: “St. Louis County has enacted T21. I will sign the same bill when the Board of Aldermen sends it to my desk.” The board does not have a proposed bill as of Sept. 12.
 
This is not the first time St. Louis County has led the way in the metropolitan St. Louis region on health-related initiatives. St. Louis County was the first in the area to impose a smoke ban in public places. St. Louis County also recently became the first to create a prescription drug monitoring program (PDMP). Missouri is the only state that does not have a statewide prescription drug monitoring program.
 
“My administration is committed to promoting policies that support optimal health for our residents and businesses,” St. Louis County Executive Steve Stenger said in a written statement to AMI. “Raising the age for tobacco purchases will immediately improve public health. Establishing a PDMP in our county will help us in the fight to stem the epidemic of prescription opioid misuse and heroin addiction. The city of St. Louis has joined our program and we look forward to others doing the same. Our efforts will save lives."
 
Harder said he reluctantly supported the PDMP.
 
“I was tepid in my support,” Harder said. “People are dying so my support was conditional. I want to make sure people’s privacy is ensured. The issue comes up this week to pick our vendor and I have to feel comfortable that we have the proper policies in place to protect people’s privacy and that it is safe and can’t be hacked. The Missouri Legislature had the same issue. Legislators couldn’t be assured about the security of the data. Other states have had their data hacked and every time that happens, it builds the case to not do it in Missouri.”
 
In May, the City of St. Louis Board of Aldermen passed a bill to join St. Louis County’s PDMP. St. Louis County’s neighbor to the west, St. Charles County, plans to introduce a bill at its Sept. 12 meeting to also join St. Louis County’s prescription drug monitoring program.