Right: Research suggests that there is a relationship between smoking and drinking. According to the data, young people are more likely to take up smoking if they frequent pubs, clubs and other places where alcohol is served. Some interpret the research results as meaning that alcohol lowers the inhibitions of non-smokers so that they are more likely to accept a cigarette or two.
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Arguments in favour of lifting the smoking age to 21
1. Smoking remains a major health, community, and economic issue in Australia
Supporters of lifting the smoking age in Australia to 21 as a means of discouraging many Australians from taking up the practice stress the enormous damage that smoking causes. They note the great harm that is done to the health of individuals, the shortening of their lives, their loss of enjoyment of life and the impact their diseases have upon their families, friends, associates, medical carers and the community at large. These costs are health based, economic and social.
Tobacco smoking is the single most significant preventable cause of ill health and death in Australia. 36,000 treatment episodes were provided by specialist alcohol and other drug agencies in 2018-19 that involved nicotine as the drug of concern. Tobacco smoke contains over 7,000 chemicals, of which over 70 cause cancer and other diseases.
In 2011, 18,800 Australians died from smoking-related disease - that is 50 preventable deaths every day. Cancer is the number one cause of smoking-related death and illness in Australia (45 percent of the total burden of disease). Smoking also leads to a wide range of diseases other than cancer including heart disease and stroke, chest and lung illnesses and stomach ulcers. Smoking-related diseases killed over 4,400 Victorians in 2011. That is over three times the number of Victorian deaths due to alcohol in the same year. One in eight Victorians who died as a result of tobacco use were aged in their 30s, 40s or 50s. Death rates from tobacco-caused disease are higher among Aboriginal and Torres Strait Islander people, who are more likely to die from these diseases at a younger age. Smoking is responsible for the deaths of two-thirds of regular consumers and is responsible for most drug-caused deaths (90 percent). By 2019, smoking-related diseases killed more than 20,000 people every year. Over 750,000 days were spent in hospital in 2004-2005 by those suffering tobacco-related illnesses which resulted in $670 million in hospital costs.
New research released in 2019 by a national team led by National Drug Research Institute (NDRI) estimates that in the 2015-16 financial year, smoking cost Australia $19.2 billion in tangible costs and $117.7 billion in intangible costs, giving a total of $136.9 billion.
The $19.2 billion 'tangible costs' include $5.5 billion that smokers spent purchasing cigarettes, $5 billion in lost productivity and worker absences, $2 billion for family members caring for someone with a smoking-related disease who effectively contribute to the health budget through their lost earnings, and the cost of 1.7 million hospital admissions to treat smoking-related conditions. Intangible costs, such as the years of life lost from premature deaths in that year or lost quality of life from living with a serious illness, were estimated at a massive $117.7 billion.
Further, the health costs associated with smoking increase over time. Cancer and many of the other conditions associated with smoking have long lead times, with an increased risk even if a person stops smoking compared with someone who has never smoked, so in 2015-16 Australia is still seeing the effects of smoking from years and perhaps decades earlier. Some of the increase in costs detected result from increases in the costs of medical care over time for many diseases. In addition, the Australian population has grown and aged; with age being a factor in many of these conditions. Together these offset some of the gains from fewer people smoking.
Smokers also have major impacts on the health of non-smokers. Health experts note that There is no safe level of exposure to secondhand smoke; even breathing a little can be harmful secondhand smoke exposure can increase a person's risk of developing a wide range of serious diseases and illnesses. It is estimated that more than 600,000 people worldwide die every year because of exposure to secondhand smoke.
2. Lifting the smoking age will reduce the number of people who take up smoking
Those who support lifting the smoking age to 21 argue that this is an important way of reducing the number of people who go on to become long-term or lifelong smokers.
Evidence suggests that lifting the smoking age significantly reduces the number of people who take up smoking. In 2005, the Boston suburb of Needham raised the legal age for purchasing tobacco from 18 to 21. The results were that tobacco use among high school students dropped by almost 50 percent, and Needham's decline in high school smoking rates outpaced those of surrounding suburbs. This prompted other United States cities and states to introduce the same restrictions.
One of the reasons offered for why lifting the smoking age reduces the number of smokers is that most smokers take up the habit when young. Therefore, it is argued, if they can be legally assisted to avoid beginning the habit at this vulnerable time in their lives, they are likely never to start smoking at all. The pattern of early onset smoking can be seen around the world. In Australia, in 2016, the average age of initiation in tobacco use was 16.4 years. The prevalence of smoking among adolescents increases with age. In Australia, in 2017, smoking was extremely rare among 12-year-olds, but by the age of 17, 12 percent of males and 9 percent of females were current smokers (i.e., reported having smoked in the past week).
A similar pattern is seen in the United States, where tobacco product use is started and established primarily during adolescence. Nearly 9 out of 10 adults who smoke cigarettes in the United States daily first tried smoking by age 18, and 99 percent first tried smoking by age 26. Almost no one starts smoking after age 25. This data clearly demonstrates that if a potential smoker in America has not taken up the habit by 21, he or she will probably not begin smoking. Australian research has suggested that young people have a particular set of life-stage factors that may make them vulnerable to beginning smoking. These include the need to deal with stress, the desire to fit in and susceptibility to peer pressure.
Research in Canada has drawn related conclusions. Jennifer O'Loughlin, a Professor at the University of Montreal School of Public Health has argued that since young people are more likely to frequent places where they can consume alcohol, they are more prone to be influenced by other smokers, or at least be more easily tempted. O'Loughlin has stated, 'Since alcohol reduces inhibitions and self-control, it is an important risk factor for beginning to smoke.' Currently, the legal drinking age and the legal smoking age in Australia are the same. If this nexus can be broken, some health professionals have suggested, fewer young Australians may begin to smoke. Finally, legally prohibiting smoking till the age of 21 may reduce the pool of people willing to supply cigarettes to underage smokers. United States data indicates that 90 percent of cigarettes purchased for underage smokers are supplied by people aged 18 to 20 years who can legally purchase cigarettes.
In the United States, the majority (59 percent) of 18- and 19-year-olds have been asked by someone younger than 18 years to buy cigarettes for them. Also, high-school students are less likely to have 21-year-old adults in their social circles than 18- to 20-year-olds, suggesting prohibiting smoking till 21 would reduce the opportunities to access tobacco from older buyers. Disrupting this well-established distribution cycle is a further reason for increasing the legal age for tobacco sales to 21 years. 3. Cigarette manufacturers target young potential smokers
Supporters of the smoking age being raised to 21 argue that this would help prevent young consumers, at whom most cigarette smoking promotions are directed, taking up the habit and potentially becoming addicted. They argue that cigarette manufacturers recognise the best way to build a smoking population is to attract young people to the habit who then become addicted users into the future.
Most forms of tobacco advertising and promotion in Australian states and territories have been progressively banned since 1973 by federal and state legislation. However, over this period, tobacco manufacturers have adapted to restrictions by targeting young people through increasing promotions in those areas where advertising is still allowed to occur - through events promotions and via upgraded products and packaging. The Internet has also become an important medium for pro-tobacco messages to young potential smokers.
In Australia and overseas, the tobacco industry has targeted young adults by sponsoring a range of events such as fashion shows, dance parties and music events, often staged in bars and nightclubs. Young adults are of key importance to the industry, providing a pool of experimenters and uncommitted smokers.
Philip Morris Australia promoted its brand Alpine through young designer fashion shows and dance parties between 2000 and 2002; these events were themed in Alpine colours and included roving cigarette sellers dressed in the Alpine colour way. Other events have featured accessories bearing brand logos, new packaging and 'special edition' product configurations, free drinks, and discounts on cigarettes. The events have encouraged participants to sign on to an email database, providing the organisers with client contact details and profiles as well as facilitating publicity about future events.
A 2019 investigation by Robert Kozinets and the Campaign for Tobacco-Free Kids uncovered tobacco companies inviting young social media influencers to parties and events where they were offered cigarettes and encouraged to pose and take photos with floor designs of cigarette brand logos placed strategically. This type of promotion encourages young 'influencers' to share photos of themselves with their many online followers, targeting a new generation of young potential consumers who are often underage and unaware that what they are looking at is effectively a paid advertisement. Although exposure to promotions of this kind may centre around young adults in the first instance, their influence can also be expected to trickle down to younger adolescents and children, who are keen to emulate adult behaviour.
Once traditional media such as television became off-limits to tobacco companies, social media platforms such as YouTube, Twitter, Facebook and Instagram have become a valuable form of relativity unregulated new media through which to attract new consumers. Online tobacco advertising is commonly encountered by young Australians, with almost one-third of the young people surveyed in 2013 reporting having been exposed. Participants of the study who were most likely to have recalled seeing online tobacco advertisements were young (12-15 years old) and/or female. Young non-smokers were also more likely to remember seeing tobacco advertising and branding than were current smokers. Tobacco advertising exposure increased over the time of the study, from 21 percent in 2010 to 29 percent in 2013, with much of the increase being seen via social media, specifically Facebook. At the time of the study, Facebook prohibited advertisements that directly promoted the sale of tobacco products; however, it did not prohibit advertisements that promoted the use of tobacco products.
Engineered products and gimmicks, designed to lure a new generation of customers into becoming addicted to nicotine, are also increasingly being used. These engineered products include 'crush-balls' - tiny plastic balls filled with flavoured liquid that are embedded in the filter of the cigarette - that can be crushed by the smoker to release flavours that make harsh tobacco more palatable to young smokers.
The Australian Secondary School Alcohol and Drug (ASSAD) Survey, conducted by Cancer Council Victoria, found that 48 percent of all underage past-month smokers in Victoria had used cigarettes containing 'crush-balls'.
In 2019, the Royal Children's Hospital National Child Health Poll found that two thirds (65 percent) of parents believe flavoured e-cigarettes encourage teenagers to take up the habit and more than half supported a ban on flavoured e-cigarettes. Most parents also supported improved enforcement of laws that ban advertising and promotion of e-cigarettes and their sales to children.
Australian Council on Smoking and Western Australia's Health Chief Executive, Maurice Swanson, have recently noted that there is currently no legislation in Australia that controls the contents or design of cigarettes and e-cigarettes. They are looking to develop legislation that prohibits the sale and importation of all tobacco products that contain flavourings including menthol; that prohibits the use of squeeze filter capsules that contain flavourings; and that requires tobacco companies to fully disclose all additives in tobacco products and the purpose for their inclusion.
In a marketplace where tobacco manufacturers are deliberately using new promotion outlets to attract young smokers, health experts believe that lifting the smoking age may limit the effectiveness of these strategies.
4. Increasing the smoking age is unlikely to foster the black-market tobacco trade
Those pushing for lifting the smoking age argue that there will not be a growth in black market supply of illicit tobacco products as a result.
It is argued that raising the smoking age to 21 would not create sufficient new demand to extend the black market in tobacco products. Smoke Free Tasmania have estimated that on current figures fewer than 1,000 potential new smokers would turn 18 each year, with around three people per day having their 18th birthday. This is both a small and gradual increase unlikely to significantly fuel black market demand. It is also argued that demand is likely to gradually decrease as the difficulties of gaining illegal access to cigarettes discourage increasing numbers of young people from taking up the habit.
It is further argued that the black market is unlikely to be the first recourse of young people not legally able to buy cigarettes. Research has shown that most young people who currently smoke illegally do not use the black market to gain their supply. Tasmanian figures indicate that among this group some 62 percent 'bot' cigarettes from friends and family. It has further been claimed that assertions that the black market in tobacco products in Australia is booming are an exaggeration. Simon Chapman, a tobacco control activist and health academic, has quoted tobacco industry figures which estimate illegal sales constitute only 15 percent of the total market. He has also cited the National Drug Strategy Household Survey which suggests that the figure is only about 2 to 3 percent of the total market.
The tobacco industry's figures, based on surveys and a range of other data estimates, suggest that in 2018, illicit products including both unbranded tobacco and manufactured cigarettes saw a decline of 15.7 percent and 7.1 percent respectively. A Border Force spokesman has also pointed to several new laws being implemented by Border Force which he claimed had 'had a positive impact on reducing illicit tobacco activity in Australia'. He stated, 'These important law reforms target the importation, possession, purchase, sale and production of illicit tobacco.'
On 1 July 2018, the Illicit Tobacco Taskforce (ITTF) was established as part of new reforms intended to tackle the black market in illicit tobacco products. In its first year of operation the ITTF detected and seized more than 262 tonnes of illicit tobacco, with an estimated excise value of more than $270 million. Such seizures are seen not as an indicator of the growing size of the black market, but as a sign of how effectively it is being combatted.
More severe punishments are also serving to combat the sale and use of illicit tobacco products. On 16 August 2018, the government passed the Treasury Laws Amendment (Illicit Tobacco Offences) Bill which created a new tobacco offence regime. The tax laws increased the set penalties to a level that provides greater deterrence to illegal activity. Penalties for possessing more than two and less than five kilograms of illicit tobacco include a civil penalty of at least $44,000. Penalties for possessing over five kilograms of illicit tobacco include a criminal penalty of a prison sentence of up to five years or at least a $222,000 fine or both. The same penalties apply for selling illicit tobacco. Penalties for manufacturing or producing illicit tobacco include a criminal penalty with a prison sentence of up to 10 years or at least a $333,000 fine or both.
Supporters of lifting the smoking age to 21 argue that the severe punishments in place for those who obtain tobacco products illegally would make this very unattractive to young people.5. Lifting the smoking age is not age discrimination
Those who support a smoking age of 21 argue that lifting the age at which it is lawful to smoke is not prohibited by anti-discrimination legislation. They further argue that such age-dependent limitations have a protective and public health purpose and finally note that the heightened addictive effects of nicotine on the adolescent brain may make it far harder for the smoker below 21 to exercise adult judgement and choose not to continue smoking.
Legally in Australia, age and other restrictions placed on smokers are not regarded as discrimination. Federal, State and Territory that laws prohibit age discrimination specifically make exemptions for laws in relation to 'liquor licensing, tobacco [sale], driving licences etc.'
The Australian Human Rights Commission has endorsed such exemptions. In addition to this, the federal Age Discrimination Act makes it legal to discriminate in the implementation of 'certain health and employment programs' Both these bases for allowing age discrimination would permit Tasmania (and other States and Territories) to lift the legal smoking age.As explained by Victoria Legal Aid, discrimination means being treated unfairly or not as well as others because of a nominated characteristic like age, sex, gender identity, race, or disability.
Supporters of lifting the legal smoking age to 21 argue that legislation that is put in place to protect a certain section of the community (such as protecting those aged between 18 and 21 from the dangers associated with smoking tobacco products) should not be described as an unjust or unfair restriction of the rights or freedoms of that section of the community.Workplace Fairness, a body which seeks to explain and protect employees' rights, has looked at the limitations imposed on smoking in the workplace. Many of the same justifications can be used to validate age restrictions on smoking. Workplace Fairness states, 'Most states have some laws that protect smokers from discrimination. However, due to the health hazards related to smoking, smokers are not completely protected in the same way that non-smokers are.' This comment acknowledges that the health dangers associated with smoking mean that it is not treated in the same way as many other activities and that legal anti-discrimination measures do not apply.
Opponents of lifting the smoking age to 21 argue that doing so denies the legal maturity of those aged 18 and above. Simon Chapman, Emeritus Professor in Public Health at the University of Sydney in a comment published in The Conversation on March 30, 2016, noted that what was important was to recognise the 'sentience and responsibility' of those aged over 18. That is, they are assumed to be old enough to make reasonable choices and to deal with the consequences of their choices.
Opponents of this view argue that tobacco consumption is an activity where this assumption of rational and reasonable choice does not apply. One of those opposing access to tobacco at 18 replied to Professor Chapman by stating, 'The difference between smoking and the other behaviours you mention is that none of them are addictive, whereas cigarettes are.'
What this implies is that the addictive qualities of nicotine mean that a young adult may lose the capacity to act on their subsequent rational desire to stop smoking. The development and maturation of the prefrontal cortex occurs primarily during adolescence and is fully accomplished at the age of 25 years. The development of the prefrontal cortex is very important for complex behavioral performance, as this region of the brain helps accomplish executive brain functions.
It has been suggested that the adolescent brain may be particularly susceptible to nicotine addiction. Two sets of research conducted in 2000, and another in 2007, have indicated that adolescent brains are particularly vulnerable to nicotine addiction. Adolescents report symptoms of dependence even at low levels of cigarette consumption. The most susceptible youth lose autonomy over tobacco intake within one or two days of first smoking. Among adolescents the appearance of tobacco withdrawal symptoms and failed attempts to stop smoking can precede daily smoking dependence and appear even before consumption reaches two cigarettes per day.
Richard J. Bonnie, Harrison Foundation Professor of Medicine and Law and director of the Institute of Law, Psychiatry, and Public Policy at the University of Virginia in Charlottesville, has stated, 'While the development of some cognitive abilities is achieved by age 16, the parts of the brain most responsible for decision making, impulse control, and peer susceptibility and conformity continue to develop until about age 25.
A balance needs to be struck between the personal interests of young adults in being allowed to make their own choices and society's legitimate concerns about protecting the public health and discouraging young people from making decisions they may later regret, due to their vulnerability to nicotine addiction and immaturity of judgment.'