It started here

Governor Jerry Brown recently signed five important tobacco control laws, made possible because of the governor’s special session on health legislation.
Of these five, the one that will have the biggest public health impact is the historic law that will increase the legal age to buy tobacco to age 21. California will become only the second state in the country to enact this change, but will inspire many to follow.
Although it took a broad coalition of passionate advocates to make this happen, Sonoma County has a lot to be proud of as the place where this legislation was born.
Fifteen years ago, with the support of the Sonoma County Medical Association, Dr Len Klay and I sponsored a California Medical Association measure to increase the smoking age in California to 21. For the next two years, aided by Dr Rob Crane of the Tobacco to 21 Foundation, bills were introduced into the legislature, but were soundly crushed by powerful lobbying forces.
Dr. Dave Anderson, a Healdsburg internist and lifelong advocate for smoking cessation, introduced this measure in Healdsburg. Despite the threat of lawsuits, the City Council, led by Mayor Jim Wood and Councilmember Tom Chambers, courageously and overwhelmingly passed this resolution in October of 2014. There was a sense of pride when our small city became the first community in California to enact a law restricting the sales of tobacco to those over 21.
Mayor Wood, now our state assemblyman, bravely sponsored this bill, also co-sponsored by local state Senator Mike McGuire and Assemblyman Marc Levine. Assemblyman Wood helped lead an extended and down-to-the-last-minute fight to make sure that this bill passed the special session despite the industry forces against it.
What made this fight worthwhile is that this will have a huge public health impact and save lives – we know this is one of the most powerful ways to prevent teens from ever starting smoking. Unfortunately, despite past successes, teen exposure to cigarettes (including e-cigarettes) has been recently increasing. The California Dept. of Public Health recently estimated that almost 300,000 California high school students are current smokers.
Take a few seconds and think back to all of the immature decisions you made in your lives when you were just 18 (and now think about your even more immature friends). It’s now thought that the female brain doesn’t mature until age 24, and the male brain about age 26.
The fact is that teen brains are not mature, and more prone to addiction – they need help to avoid picking up this lifelong habit. We know that most kids under 15 who smoke are getting their cigarettes from their 18-year-old acquaintances and that studies show this access decreases precipitously when the age is increased to 21. The city of Needham, Massachusetts, was the first community in the U.S. to increase the age for tobacco sales in 2005, and has seen a drop of more than 50 percent in its youth smoking rate.
According to the Surgeon General, 90 percent of smokers have already started smoking by age 18. Only one-third of young smokers will ever quit, and one-third will die from tobacco-related causes. If you haven’t smoked by the 18, you are three times less likely to smoke, but if you haven’t started by 21, you are 20 times less likely to ever smoke.
As an OB-GYN, I personally still see the effects of smoking all of the time – from an increased risk of infertility, small babies, and preterm delivery – to an increased risk of heart disease and cervical, ovarian, bladder, breast and lung cancers. I know that although 90 percent of pregnant moms quit smoking during pregnancy for nine months, two-thirds go back to smoking after their pregnancies. This is how addictive tobacco is.
As councilmember Susan Jones said at the time of Healdsburg’s ordinance: “If you want something done, do it locally.” I just wanted to congratulate and thank all of those local heroes who worked so hard on this – it really does show what an impact a local community can have.
Brad Drexler MD is an Obstetrician
Gynecologist in Healdsburg and Santa Rosa