Tobacco 21 paves the road for a healthier future

Peters Pisters, Presidente at MD Anderson Cancer Center

It has been 55 years since the U.S. Surgeon General’s first Smoking and Health report linked smoking cigarettes with dangerous health effects, including lung cancer and heart disease. For nearly six decades, our children have grown up with the knowledge that cigarettes cause major harm to their health. Yet today, more than two-thirds of tenth grade students and nearly half of eighth grade students say it is easy to get a cigarette.

As a parent who has worked hard to raise awareness about the dangers of smoking, these statistics are shocking. As a health care provider and president of The University of Texas MD Anderson Cancer Center, the statistics are even more devastating.

Yet the Texas Legislature’s recent passage of Senate Bill 21 — also known to many as Tobacco 21 — on May 21 should bring us all a sense of hope. The bill, which was authored by Sen. Joan Huffman and sponsored in the House by Rep. John Zerwas, M.D., raises the minimum legal sale age from 18 to 21 for the purchase of cigarettes, e-cigarettes and all other tobacco products.

With the bill’s passage, Texas now joins 14 other states and more than 450 cities and counties in raising the tobacco sale age to 21. This is an important step toward protecting the health of future generations and reducing the burden of tobacco use in Texas.

Tobacco 21 will not only decrease tobacco usage in the years ahead; it will prevent electronic cigarettes from reaching our youth and reduce the ravages of cancer, cardiovascular disease and lung disease for future generations.

A top priority for cancer prevention

Despite significant success in lowering youth and adult smoking rates, tobacco use remains the leading cause of preventable death and disease in the United States. Tobacco use claims an estimated 480,000 lives each year in the U.S., with 28,000 deaths in Texas alone, according to the Centers for Disease Control and Prevention. That’s why this legislation was MD Anderson’s top legislative priority this session. Through collaborative efforts of MD Anderson’s EndTobacco® program, Governmental Relations team and Cancer Prevention and Population Sciences division, our experts served as a clinical and scientific educational resource on this issue for state legislators. MD Anderson also helped to establish and served as an educational resource for a statewide Texas 21 coalition of public health organizations, health care providers, trade associations and many others.

Over the course of the current session, I traveled to Austin several times to participate in meetings with leaders of the MD Anderson Cancer Center Board of Visitors to educate state leaders, and key House and Senate members serving on health and budget committees about the impact of this legislation on youth tobacco prevention, overall public health and the reduction in tobacco-related illness and related health expenditures. These meetings allowed MD Anderson to share its unique perspective, as our clinicians are front line caregivers for patients and survivors impacted by tobacco related illnesses. It was gratifying to serve as a state resource on a critical health policy with significant implications for Texans and to witness the compassion and dedication of state leaders and lawmakers firsthand.

Research shows that raising the tobacco sale age saves lives

By limiting youth access to tobacco products, raising the tobacco sale age is intended to lower the future burden of tobacco use. Approximately 95% of adult smokers began smoking before age 21.

Research shows that by increasing the sale age for tobacco to 21 across the U.S., future smoking rates would drop by an estimated 12%, with a corresponding 10% reduction in smoking-related deaths and nearly 250,000 lives saved.*

For every three young people prevented from using tobacco because of this law, there will be one fewer cancer-related death in the future.

With 26.2% of Texas population under the age of 18, this legislation will have a lasting impact on future generations of Texans.**

Texas’ Tobacco 21 legislation sets an important example

While many states and hundreds of municipalities have adopted this policy across the nation, passage in Texas could influence the consideration and approval of legislation in other states in this region of the country.

I congratulate the Texas Legislature for this monumental legislation, which will have a profound impact for Texans. My children, my children’s children and countless children to come will benefit.

* According to a report from Health and Medicine Division of the National Academies of Sciences, Engineering and Medicine (formerly the Institute of Medicine),

** (Source: Texas population, US. News and World Report Analysis of Best States – https://www.usnews.com/news/best-states/slideshows/the-most-youthful-states-in-america?slide=10)