Senators Mitch McConnell (R-KY) and Tim Kaine (D-VA) have recently proposed a bill to raise the legal smoking age from 18 to 21, across the United States. Currently, most US states allow 18-year-olds to purchase and smoke tobacco products, although 14 states set the age limit at 21.
McConnell has stated that this bipartisan legislation will be “one of his highest priorities.”
As a physician, I think smoking is a terrible idea. But I also think it’s a terrible idea for the government to forbid mentally competent 18 to 20-year-old adults from smoking.
I can see why parents, health professionals, and legislators might be alarmed at the idea of young adults smoking. A 2015 report from the Institute of Medicine argued if the smoking age were raised to 21, “there would be approximately 223,000 fewer premature deaths, 50,000 fewer deaths from lung cancer, and 4.2 million fewer years of life lost for those born between 2000 and 2019.”
In a related CNN opinion piece, US Senators Brian Schatz (D-HI) and Todd Young (R-IN), also argued that the age should be raised to 21 in part because smoking-related illnesses cost taxpayer money “in the form of higher Medicare, Medicaid and other health care costs” and that “smoking-related illness in the United States costs more than $300 billion a year.”
Numerous organizations, including the American Cancer Society, American Heart Association, American Lung Association, and the American Academy of Pediatrics also support raising the smoking age to 21.
I disagree strongly with those politicians and those organizations. As an advocate for individual liberty, I want to ask a few questions:
1) Is it the government’s job to stop legal adults from making unhealthy life choices?
If the government can prevent an adult 18-year-old from smoking, can they also stop him or her from eating too many chocolate chip cookies? Or require that they eat enough vegetables?
From an economic perspective, it is true that unhealthy life choices such as smoking will lead to increased medical costs. But in a free society, that can be dealt with by allowing health insurance companies to charge smokers higher premiums. Smokers themselves can and should cover their own increased medical costs of lung cancer, bronchitis, emphysema, etc.
It is only within socialized health systems where people are forced to pay for others’ health care that smoking becomes a burden on non-smokers. And even in a government-run health system (which I oppose), it is possible to require smokers to pay a surcharge to cover the increased medical costs of their life choices.
Cigarette smoking IMAGE BY PAOLO NEO (PUBLIC DOMAIN), VIA WIKIMEDIA COMMONS
2) If Congress allows 18-year-olds risk their lives in military service, shouldn’t they also be allowed to smoke?
I recognize that below a certain age, young people cannot give meaningful consent for contracts, medical procedures, and other major life decisions. Currently, the law recognizes that age of majority as 18. But after someone turns 18, he or she is regarded as an adult who can vote, join the military, give consent for major surgery, or sign binding contracts.
If 18-year-olds can decide whether or not to assume the risks of major surgery or serving in the military, they should also be able to decide whether or not to assume the risks of smoking. I don’t think it’s right for the US government to tell a 19-year-old serving in Afghanistan or Iraq that he or she can take a bullet for their country, but they may not smoke a damn cigarette.
Conversely, if 18-year-olds are considered insufficiently competent to decide whether or not to smoke, then perhaps Congress should also raise the minimum age for military service to 21.
(Note: According to USA Today, Senator McConnell said he initially intended to exempt members of the military from the proposed law, but changed his mind “after discussions with constituents and public health advocates.”)
3) Whose body is it, anyways?
The political Left has long defended abortion rights with slogans such as, “Our bodies, our choice” (a view I agree with). This principle of bodily autonomy should also apply to other life choices, such as smoking. This is just part of the broader principle of individual rights.
But while you have right to smoke, you cannot do so in a fashion that violates others’ rights. You have the right to smoke on your own home or property, or on another’s property with the owner’s consent. But restaurant or business owners have the right to forbid smoking on their property, just as they have the right to require that customers wear shoes and shirts.
As a physician, I think smoking is a terrible and foolish idea. But as an American, I respect and defend every adult’s right to make that decision for themselves. (This is analogous to respecting and defending everyone’s right to free speech, even if some people exercise that right to express foolish or offensive opinions.)
Your life is yours to live — not Senator McConnell’s. Don’t let anyone tell you otherwise.