Over the past several months, teams of local health advocates have been making their way from one local city to another, lobbying city leaders to raise the legal age for the purchase of tobacco to 21.
Since its launch last October, Tobacco 21, a coalition made up of business, government and health groups, has run up a string of victories in some of the area’s largest cities, including Kansas City, Missouri; Kansas City, Kansas; and Olathe, Kansas.
But the reception they got in Gardner, Kansas, on March 21 was a first.
After representatives from the coalition made their case, the Gardner city council began pummeling them with questions, including one from Councilman Rich Melton, who asked one of the presenters what she had for lunch.
Upon hearing “lentils,” Melton began making his case.
“Can you imagine if I said I didn’t like lentils, and I said nobody should eat those?” Melton declared. “They’re disgusting. They make me sick to my stomach. I think we should ban those.”
Over the next hour, the council did little to hide its opposition to the proposal. They made it clear that their ideas about the proper role of government were odds with the advocates’ hopes of improving public health through public policy.
After some further passionate condemnation of the proposal and more than one evocation of the Founding Fathers, the council rejected the proposal. The vote was a unanimous 5-0.
Personal Freedoms
A few days later, Melton agreed to meet with a reporter at Groundhouse Coffee, a shop a block from city hall, and to talk about what happened.
Gardner is about 30 miles southwest of downtown Kansas City, with a population that has more than doubled to 20,000-plus since the 1990s. Melton grew up in Lawrence, Kansas, and moved here about 15 years ago.
Explaining his opposition to Tobacco 21, he insists it wasn’t out of any love for tobacco.
“No, not at all! I hate the stuff. I really do,” Melton said. “But personal freedoms, to me, are things we don’t just give away, and I think that’s what some of these cities north of us, their councils aren’t realizing.”
Melton makes his living selling concealed carry gun holsters, and he says he decided to get into politics last year and run on a platform of freedom and personal responsibility.
Restricting teenagers from making their own choices, he says, is counterproductive.
“I don’t think every 18-year-old is responsible,” Melton says. “I think we, as a society, need to work harder on making them more responsible. I think children are coddled now.”
Ultimately, he says, proposals like the one to raise the tobacco purchasing age fly in the face of the ideals on which the country was founded.
“When we moved here from Europe and all the other countries of the world, we moved here for freedom. And I think America’s lost sight of that,” Melton said. “Because so many things like this happen. Oh, it’ll just be smoking for 21, then – all of a sudden – it’ll be you can only have two cheeseburgers a month. It incrementally happens where things get taken away. And I think people are waking up to that.”
Protecting teens
Gardner is also the hometown of Dr. Roy Jensen. He’s the director of the University of Kansas Cancer Center and one of the advocates who tried to make the case for Tobacco 21 in Gardner.
He was baffled by the reaction.
“It’s hard for me to understand,” Jensen said a few days after the vote.
Jensen cited recent research showing that teens’ brains aren’t fully developed until they’re about 25 and how susceptible they are to advertising, social pressure and risky behavior.
A law protecting them from those influences, he said, just makes common sense.
“There’s no question that the tobacco industry’s goal is to get as many people – have them become lifelong smokers – as possible,” Jensen said. “It’s unfortunate when folks believe that some kind of fight around personal liberties puts them on the side of Big Tobacco.”
Jensen said the damage of tobacco extends beyond individual users and it’s more than just second-hand smoke. Kansas taxes cigarettes at $1.29 a pack, and much of the money goes to public health programs. But the diseases and conditions caused by smoking, including heart disease, cancer and birth defects, create huge costs for the state’s Medicaid and other health programs.
One study has shown the cost to the state for each pack of cigarette sold is around $14.
“The tobacco industry is one of the most heavily subsidized industries in the country, because they are cost shifting all of the health care costs to somebody else,” Jensen said. “The tobacco tax and the amount that’s collected is really a pittance when you compare that to the cost of smoking-related disease to the Medicaid program.”
But ideas about the proper role of government in dictating people’s choices are deeply felt – and not just in Gardner. Other cities have rallied against proposals to ban large-size soft drinks and to change public school lunches.
Tatiana Lin is an analyst with the Kansas Health Institute. She says resistance to public health programs is not uncommon.
“Those type of discussions do come up,” Lin said. “I think there’s basically several schools of thought in terms of shared responsibility versus personal responsibility.”
Tobacco 21 probably won’t be adopted anytime soon in Gardner, although the program’s supporters remain hopeful that other communities will take up the challenge. Bonner Springs, Grandview, Leawood, Lenexa and Overland Park are slated to consider the initiative in coming months.
But as communities struggle to deal with growing public health problems like obesity and diabetes, public health workers may have their work cut out for them.
“I think one of the things we really need to learn in public health is being able to speak the languages of other sectors and really be able to frame and think about priorities from perspectives of other players and really package or frame the argument a little bit differently,” Lin said.
