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Patricia Garson was a smoker who died of lung cancer. Her husband inhaled second-hand smoke for over 20 years and died of lung cancer too. Their daughter smoked for 30 years and has lung cancer. And their son — a co-author of this column — smoked for three years. One thing uniting those Garsons: Their smoking began in their teenage years.

Unfortunately, this experience is far too familiar for many Americans. Tobacco is the leading cause of illness and death in the United States, claiming the lives of nearly half a million people each year. That is equivalent to three 747 planes crashing in this country every single day. However, we have the opportunity to prevent today’s teenagers from the harms experienced by the Garson family. The question is, are we willing to seize it?

There is an effective solution that can dramatically curb smoking — and one that has broad, bipartisan support. Across the country, several states and hundreds of cities have passed a law that can help ensure teenagers never start smoking — and therefore, never become addicted. These laws, known as “Tobacco 21 laws,” make it illegal to sell cigarettes and other tobacco products to anyone under the age of 21.
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Nationally, 82 percent of Americans support preventing the sale of all tobacco products to those under age 21, according to a 2018 poll conducted by Texas Medical Center Health Policy Institute, to be released Wednesday.

Both Republicans and Democrats back these laws to keep tobacco out of the hands of teenagers. Support for the laws is high across different income and education levels. Support is high even among those under 21, who are most directly affected.

It’s important to enact these laws because teens are especially susceptible to the addictive effects of nicotine. Young people need less nicotine than adults to become addicted, and their impulsivity prevents them from recognizing the serious risks they face if they choose to become smokers. But if you prevent them from smoking when they’re under 21, many will choose not to take up smoking, even when they’re of legal age.

This year, cryptic signs for something called Juul began appearing in the windows of the 7-Eleven on my block. On vacation in Miami, where smoking is still allowed in many clubs, I noticed a pretty young woman pull a Juul from her purse and lay it on the bar, next to her cocktail. This summer, I saw Juuls at a Fourth of July crab crack and Juuls on the city bus.

Juul, if you haven’t heard, has quietly become the most popular new way to smoke since the old coffin nail itself, claiming more than half of the booming market for electronic cigarettes.

Where early e-cigs tended to mimic cigarettes — and hilariously generated more smoke than a fog machine — the Juul is as far removed from a cigarette as you can get. A sleek little brick that looks like a USB flash drive, it flickers with colored light, puffs discreetly and smells like nothing at all. It is the iPhone of smoking, and the kids are wild for it.

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But Juuling, health professionals say, also carries the dangers of the death stick of the past. It is raising alarms by hooking youth on nicotine at a time when old-fashioned smoking has been hitting a steep decline.

The secret to Juul’s controversial success may be a twist on the age-old story of smoking as an outlet for teenage rebellion. The popularity of Juul seems to grow in tandem with the uproar: Sales of Juul are up more than 700 percent from a year ago, according to Nielsen data.

Schools across the country say they are confiscating fistfuls of the things from their underage charges. Three lawsuits were recently filed against Juul Labs; each argues that users as young as 14 became addicted to Juul, and that the product was marketed as safe.

To Allan M. Brandt, a historian and author of “The Cigarette Century,” Juul is anything but new and different. “It represents the cultural norms and notions of the cigarette, which was very much youth-oriented,” he said. “It was kind of forbidden; it was extremely cool.” . . .
“I think the history of this tells me, don’t trust these industries,” said Brandt, the smoking historian. “Juul can say, ‘We’re not interested in kids; we’re going to fight the use of this in kids.’ But with flavors like mango, and cool cucumber. . . .”

“Cigarette makers have always said they didn’t want kids to smoke, he continued. But bad news about children lighting up on the schoolyard, he said, “was always great news for the tobacco companies.”

I think back on my own generation, which was in its teens when we watched Kurt Cobain on MTV, coolly dragging on a cigarette between strums of his acoustic guitar. And then, for a brief while, I smoked Parliaments on stoops in New York, too, till it became too expensive to continue. We straddled the time when all the fun kids loitered outside smoking, and the moment when, abruptly, the cigarette became social napalm.

Matthew L. Myers, President, Campaign for Tobacco-Free Kids, issued a press release thanking Rep. Paul McMurtry and Sen. Jason Lewis for their leadership in sponsoring legislation that prohibits the sale of tobacco products to anyone under 21 and includes other important public health protections.

With final passage by the Legislature today, Massachusetts is poised to become the sixth state to prohibit the sale of tobacco products to anyone under 21.  This legislation will prevent young people in Massachusetts from starting to use tobacco, save lives and help make the next generation tobacco-free.

In addition to raising the tobacco age to 21, the Massachusetts legislation prohibits pharmacies from selling tobacco products and adds e-cigarettes to the state’s smoke-free law. Massachusetts will be the first state to enact a statewide prohibition on tobacco sales in pharmacies. In his press release, Myers highlights the importance of this legislation to Massachusetts:

“In Massachusetts, tobacco kills over 9,300 people and costs over $4 billion in health care expenses each year. Without additional action to reduce tobacco use, over 100,000 kids alive today in Massachusetts will die prematurely from smoking. Increasing the tobacco age to 21 is a critical step in reducing and eventually eliminating tobacco’s terrible toll.”