Middle school children are vaping in school, hiding paraphernalia in bathroom ceiling tiles, due to the effortless availability and need to be a part of the latest fad that is killing our children. West Virginia residents ages 18 and older are dying for oxygen related to a breath-taking disease, chronic obstructive pulmonary disease (COPD) placing it as one in the top eight lung diseases in the U.S., with the highest prevalence in the nation at 13.9 percent (Fast Facts, 2016).

This disease is irreversible, and debilitating leaving loved ones in West Virginia with reduced airflow, lung elasticity, and restricted airways with overproduction of mucus directly related to tobacco. As the fourth leading cause of death in the U.S., tobacco smoke is an essential factor in the growing development of COPD that’s destroying West Virginia (Chronic Obstructive Pulmonary Disease, 2018). Witnessing this disease, as a registered nurse and senior graduate student, produce fear in the eyes of patients is disheartening, especially since this is largely preventable, though investors in the tobacco industry may argue otherwise.

Nine and one half billion (9.5) U.S. dollars have been devoted to advertising and promotion of cigarettes and smokeless tobacco, leaving an economic cost of smoking over $300 billion a year, including $170 billion in direct medical care for adults, and more than $156 billion lost due to early death (Smoking & Tobacco Use, 2019). The Center for Disease Control (CDC) estimates that in 2019, states will collect a record $27.3 billion from tobacco taxes, spending less than 2.4 percent on programs that can stop young people from becoming smokers and help current smokers quit (Smoking & Tobacco Use, 2019). Out of 50 states, right now, none fund these programs at the CDC’s recommended level, but two states (Alaska and California) give more than 70 percent of the full suggested amount, while three states (Connecticut, Tennessee and West Virginia) give zero state funds for prevention and smoking cessation programs (Smoking & Tobacco Use, 2019). We need to consider the health of our state of great importance, as we are a powerful investor in protecting the welfare of our youth.

Currently in West Virginia one has the availability to purchase tobacco products at age 18, which increases exposure of harmful chemicals in tobacco adding to the development of COPD (Chronic Obstructive Pulmonary Disease, 2018). Tobacco, the first causal and single most central risk factor for COPD, to include personal exposure to smoke, from family members smoking or lingering nicotine and other harmful chemicals on surfaces (López-Campos et al 2016). Increasing the legal age for the purchase of tobacco, tobacco products, tobacco-derived products, alternative nicotine products, and vapor products to 21, our West Virginia Legislature offered Senate Bill (SB) 348 titled “Relating to tobacco usage restrictions,” as a solution to this crisis in West Virginia. The Senate found this an important issue, but the House Health and Human Resources in February allowed this bill to “die,” just as the people of West Virginia are. Making tobacco less available to youth starts with people speaking not only to community representatives, but to both state and federal appointed representatives. Making our concerns understood, reducing early exposure to tobacco will decrease deaths related to COPD through increasing the legal purchase age to 21.

Smoking during one’s youth is more likely to lead to addiction and daily smoking (U.S. Department of Health and Human Services, 2012). Most adults purchasing cigarettes for high school students are under 21, raising the tobacco purchase age, students are less likely to have 21-year-olds than 18-year-olds in their social circles, reducing access to tobacco from older buyers (Winickoff, et al, 2016). The CDC reports approximately 9 out of 10 cigarette smokers first tried tobacco products by age 18, and each day in the United States, approximately 2,000 youth under 18 years of age smoke their first cigarette, and more than 300 youth under 18 years of age become daily cigarette smokers (Youth and Tobacco Use, 2019).

As of 2019 six states: California, New Jersey, Maine, Massachusetts, Hawaii and Oregon took the lead in breaking the supply cycle of tobacco, limiting regular smoking among their youth, preventing minors’ ability to buy from other high school students with raising tobacco purchase age to 21 (Youth and Tobacco Use, 2019). Watching relatives, like many in West Virginia, depart this life too soon because of tobacco use, we have a duty to unite forces in West Virginia joining these six states to fight for tobacco-free kids.

Enactment of SB 348 will take everyone writing and calling your representative to place it back on the legislative radar making the legal age for purchase of tobacco in West Virginia 21.


• Chronic Obstructive Pulmonary Disease. (2018, February 13). Centers for Disease and Prevention: Retrieved from https://www.cdc.gov/copd/for-clinicians.html

• Fast Facts. (2016). Division of Health Promotion and Chronic Disease: Retrieved from https://dhhr.wv.gov/hpcd/data_reports/Pages/Fast-Facts.aspx

• López-Campos, J., Tan, W., & Soriano, J. (2016). Global burden of copd. Respirology, 21(1), 14-23. doi:10.1111/resp.12660

• Millett, C., Lee, J., Gibbons, D., & Glantz, S. (2011). Increasing the age for the legal purchase of tobacco in England: Impacts on socio-economic disparities in youth smoking. Thorax, 66(10), 862-862. doi:10.1136/thx.2010.154963

• Smoking & Tobacco Use. (2019.February 6). Centers for Disease Control and Prevention: Retrieved from https://www.cdc.gov/TOBACCO/DATA_STATISTICS/FACT_SHEETS/FAST_FACTS/INDEX.HTM

• US Department of Health and Human Services. Preventing tobacco use among youth and young adults: a report of the Surgeon General. 2012.

Graham is a BSN senior graduate student in the West Virginia University School of Nursing.

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