Tobacco 21: Forging Ahead on Public Health Policy in Washtenaw County

by Elisabeth Vanderpool, Director of Community Health, St. Joseph Mercy Ann Arbor and Livingston

The city of Ann Arbor is making bold moves to prevent tobacco-related deaths. In early August 2016, the Ann Arbor City Council passed a landmark ordinance to raise the legal age of purchasing tobacco products from 18 to 21. The ordinance went into effect Jan. 1, 2017, and Ann Arbor joins over 170 localities in 13 states, in addition to the entire states of Hawaii and California, that have raised the tobacco age to 21. A March 2015 report by the Institute of Medicine (IOM), one of the most prestigious scientific authorities in the United States, strongly concluded that raising the tobacco sale age to 21 will have a substantial positive impact on public health and save lives. The report predicts that raising the minimum age for the sale of tobacco products to 21 will, over time, reduce the smoking rate by about 12 percent and smoking-related deaths by 10 percent, which translates into 223,000 fewer premature deaths, 50,000 fewer deaths from lung cancer, and 4.2 million fewer years of life lost.

National data shows that 95 percent of adult smokers begin smoking before the age of 21, and in Michigan, over 10,000 children become new regular, daily smokers each year, a third of whom will die from their addiction. Moreover, the brains of people under 21 are still developing, making them more susceptible to the addictive properties of nicotine, and to smoking longer. Additionally, Washtenaw County Public Health’s Health Improvement Survey conducted in 2015 showed an uptick in tobacco use rates in the county to 15 percent, the first time there has been an increase since the inception of the survey in 1995.

Due to these supportive facts, St. Joseph Mercy Ann Arbor has been a strong supporter of the Tobacco 21 ordinance. The hospital’s current Community Health Needs Assessment, done in collaboration with Michigan Medicine and St. Joseph Mercy Chelsea, highlights substance abuse as one of its priority health needs, of which tobacco use falls under. Furthermore, in St. Joe’s Implementation Plan, developed to address priority health needs discovered through the assessment process, reducing tobacco use among adults and youth was named as a goal. St. Joe’s stands behind the notion that upstream preventive measures are valuable in a multi-tiered approach to improving overall community health and well-being. Raising the minimum legal sale age for tobacco complements other proven upstream public health strategies to reduce tobacco use and save lives, including comprehensive smoke-free laws and implementation of evidence-based tobacco prevention and cessation programs.

For more on St. Joseph Mercy Ann Arbor’s Community Health and Well-being strategies, visit

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