Oncologist supports 'Tobacco 21' initiative

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Stop smoking

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Indiana has a higher-than-national-average number of smokers. Aside from the health issues that smoking presents for individuals, tobacco users cost the state an estimated $3.17 billion annually in lost productivity and the average family $1,000 annually in taxes to cover medical costs. Tobacco 21 aims to address those issues.

The initiative, which would raise the legal age to purchase tobacco products as well as vaping liquids that contain nicotine, “absolutely” would reduce the number of teenage smokers who become adults smokers, said Dr. Nasser Hanna, professor of medicine at the Indiana University School of Medicine in Indianapolis. 

Hanna, a medical oncologist who treats cancer patients, said in a phone interview with the Indiana Business Daily that most studies show 15 percent to 25 percent of high school students are going to be smokers, that most adult smokers started as teens, and that the younger people are when they start smoking, the harder it is for them to quit.

“If you can prevent someone from smoking until they are 18, you can lower the rate 20 percent,” he said. “Raising the age to 21 will further advance that to 10 or even 5 percent.”

Although laws do not necessarily keep teenagers from getting their hands on forbidden fruit, many more younger teens know 18-year-olds who can buy products for them than know 21-year-olds they can persuade to so the same.

Thus, said Hanna, although “the change from 18 to 21 is not going to eliminate” all the problems associated with smoking, it will significantly reduce them.

“First,” he said, “it establishes that our society through legislation understands that teenage use is a crisis. It makes a statement that we understand as a society that the teenage brain is still developing, and the risk of addiction is higher in the undeveloped brain.”

Electronic cigarettes are far from an antidote, he noted. In fact, they exacerbate the problem.

“Vaping”—the process of inhaling through smokeless e-cigarettes—is becoming an epidemic among teenagers, according to the National Institute on Drug Abuse. And aside from the habit leading as a gateway to cigarette smoking, it presents other problems, Hanna said.

“We do not have long-term data on chronic vaping in the teenage lung, but we do have nicotine," he said. "And we do have irritants to the lung and we have trace carcinogens. We know that chronic inflammation is a factor in a number of diseases, and we know that chronic exposure (to trace carcinogens) over years and years (can lead to cancer).

“Nicotine is highly addictive, especially to a young person’s brain. And while it’s not in itself carcinogenic, it’s not a good thing to inhale irritants in their lungs. It’s not a good thing to be addicted.”

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