Minnesota is a laggard in raising tobacco age to 21

Minnesota ought to be leading the pack when it comes to a straightforward health reform that would save lives and constrain care costs — raising the tobacco purchase age from 18 to 21 statewide.

While individual communities merit praise for making this move, a statewide change is the most effective way to safeguard young Minnesotans against a lifetime of nicotine addiction and the serious health risks accompanying it, including cancer, heart disease and emphysema.

Yet the state is a laggard in making this change. Eleven states have now passed so-called "Tobacco 21" laws. Included on the list are perennial public health front-runners such as Hawaii, Oregon and California. Other states include Arkansas, New Jersey and Virginia.

Last week, Illinois became the first Midwest state to make the change. It defies understanding how Minnesota, a state that won a landmark settlement against tobacco companies two decades ago, has yet to enact this critical public health protection.

Thankfully, Minnesota has well-crafted legislation in both the House and the Senate to move to 21. Both bills smartly include e-cigs, or "vaping" devices, in the restrictions. But there are mixed signals about whether there's momentum to make the change this year.

The bill has made admirable progress in the House, where freshman Rep. Heather Edelson, DFL-Edina, is the lead author. The measure is now included in a bigger bill expected to go to the House floor later this month. Regrettably, there's less movement in the Senate, though there is welcome bipartisan support there. Sen. Carla Nelson, R-Rochester, is the bill's chief author.

There's still plenty of time for the age change to pass before the Legislature adjourns next month. Still, there are no guarantees, and it's disappointing that this reform wasn't included among the targets to pass early in the session.

More than 30 Minnesota cities or counties have already adopted Tobacco 21, suggesting there's a groundswell of support for such an initiative. Tobacco use is also still the leading cause of preventable death and disease in the state, with an annual death toll of more than 6,300 people, according to retired Mayo Clinic physician Richard Hurt. Voting yes involves little if any political risk.

In addition, there's an urgency to putting protections in place for teens. "Frankly, there is an epidemic of tobacco use among our young people that threatens to roll back the decades of progress we have had in reducing smoking rates," said Robert Moffitt, communications director for the American Lung Association in Minnesota. "For the first time in 17 years, we have seen youth tobacco use go up. More than 26% of high-school students surveyed by the [Minnesota Department of Health] reported using tobacco products in the past 30 days."

Concerns about this "epidemic" are amplified by new appreciation of how brains continue to develop in late adolescence and early adulthood. The part of the brain responsible for judgment and impulse control isn't fully mature until age 21 or beyond. That undercuts one of the main arguments against raising the age — that those 18 and older are able to make an informed judgment about tobacco's risks.

The argument that tobacco sellers near state borders may lose business is also weak. According to Edelson, just 2% of tobacco sales come from people ages 18 to 21. The amount of lost revenue is also dwarfed by the savings in future years by preventing tobacco-related illness.

"We can't sacrifice our kids for 2% of sales,'' she said. "The same objections probably came up when alcohol was moved to 21. We passed it because it was the right thing to do."

Improving health outcomes while containing costs is one of the most complicated challenges facing this generation of policymakers. Simple, elegant solutions to accomplish both are elusive. Raising the tobacco age is the exception, and Minnesota lawmakers should seize the opportunity at hand.