Letter to the editor: On Princeton Board of Health's proposed tobacco sale prohibitions

TheDaily Princetonian articlepublished on Feb. 19 about the Princeton Board of Health’s potential prohibition on tobacco sales to individuals under 21 featured some students’ views on the effectiveness of the proposed ordinance. The Student Health Advisory Board would like to use this opportunity to broaden the context and draw attention to the public health implications of tobacco use and prevention.

According to the National Institutes of Health, tobacco use is the leading preventable cause of disease, disability and death in the United States. Overall mortality of smokers in the United States is approximately three times higher than that among similar people who have never smoked. Cigarette smoking results in over 480,000 deaths each year, and an additional 16 million people suffer with a serious illness caused by smoking, according to the Centers for Disease Control and Prevention. It’s also important to remember that tobacco products affect not only smokers, but also nonsmokers. Exposure to secondhand smoke causes approximately 3,400 lung cancer deaths and 46,000 heart disease deaths in adult nonsmokers annually in the United States, according to the California Environmental Protection Agency.

The American Cancer Society says that over two-thirds of smokers want to quit. Although about half try each year, fewer than 10 percent succeed without help such as medication or behavioral therapy. This contrasts to successful quitting rates of 18 percent among alcoholics and over 40 percent among opiate or cocaine users. A single piece of chewing tobacco used for 30 minutes delivers as much nicotine as three cigarettes, and one cigar can contain as much as an entire cigarette pack.

Prevention has become an increasingly emphasized strategy, especially among adolescents and young adults. Over 80 percent of adult smokers begin smoking before 18 years of age, with 99 percent of first use by 26 years of age. According to a report by the Surgeon General, “It is perhaps less appreciated that early addiction is the chief mechanism for renewing the pool of smokers. Most young people who are going to smoke are hooked by the time they are 20 years old.” Many of you may remember initiatives in your middle or high schools.

In addition to these explicit educational programs, policy changes are another avenue by which messages can be more implicitly communicated with citizens. Some major cities, including New York, have prohibited smoking in enclosed workplaces. In March 2013, Princeton became the first Mercer County town to ban smoking on properties like municipal buildings and parks, with increasing fines for subsequent violations. Regardless of whether the new ordinance does, in fact, prevent late teens from acquiring or using tobacco products, it provides an unequivocal message that young people should not be using them. It is worth noting that models of raising the smoking age to 21 estimated that the smoking prevalence would drop 67 percent in 14- to 17-year-olds and 55 percent in 18- to 20-year-olds.

Ultimately, SHAB is expressing neither skepticism toward nor a political stance on the proposed ordinance.We simply hope to continue the discussion and offer another view — a public health view — of the policy in addition to the student views already introduced in the article.SHAB’s goal is that all students understand the risk associated with smoking and are acting in the best interests of themselves and those around them.

Respectfully,

Student Health Advisory Board