A bill introduced by Rep. Teresa Tanzi, D-Narragansett and South Kingstown, proposes to increase the legal age to buy or sell tobacco products in Rhode Island from 18 to 21 years old. After being introduced in February, the legislation entered the hearing stage last week, spurring debate between medical professionals, politicians and other interested parties.

Similar legislation has been passed in municipalities across the country, but the legislation’s passage would make Rhode Island the first state in the nation to raise the legal age for purchasing or selling tobacco to 21.

“There’s very good research that decision-making among 18 to 21 year olds is still not fabulous,” said Patricia Risica, professor of epidemiology.

“The kind of social pressures put on them override what they know to be a bad decision,” Tanzi said.

Increasing the legal age not only decreases the risk of smoking in that age group but also reduces access to cigarettes for underage youth who get their tobacco products from young adults, Risica said.

The municipal government in Needham, Massachusetts passed an ordinance raising the age of buying tobacco to 21, which immediately decreased the percentage of people under 21 who have smoked within the last 30 days by 48 percent, Tanzi said. New York City also enforces the older legal age.

A hearing for the bill was held by the House Committee on Health, Education and Welfare March 25. Opponents cited an overstep in government regulation as one of the bill’s defects. Some pointed out that 18-year-olds are allowed to vote and join the military, and they should have the right to make decisions for themselves, the Providence Journal reported March 26.

Raising the age could also cost the state to lose tax revenue from cigarettes, said Scott Mackay, political analyst for Rhode Island Public Radio, adding that Gov. Gina Raimondo’s recently unveiled budget proposes an additional 25 cents-per-package increase on the state cigarette tax.

“There’s nothing to stop a young person between 18 and 21 to just drive 3 or 4 miles over the border and go to Massachusetts to buy cigarettes,” which would hurt R.I. retail sales, MacKay said. “This would be a much easier choice if Massachusetts did the same thing.”

Small business owners testified against the bill at last week’s hearing, said Karina Wood, public policy director for the American Lung Association, adding that while the association supports the state’s small businesses, “there are many other things that convenience stores and gas stations in Rhode Island can sell and make good money.”

Cigarette sales to the 18 through 20 age group make up 2 percent of convenience store sales, Tanzi said. “It’s a drop in the bucket,” she added.

The money lost would be made up by savings on health care expenditures on tobacco-related illnesses, Tanzi said.

Brain development and growth in self-regulation continue past the age of 18, according to an FDA-initiated study from the Institute of Medicine entitled “Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products.”

“High-risk behaviors, including tobacco use, are generally more common in adolescents and young adults than in older adults,” the IOM reported. “Additionally, the tobacco industry, prohibited from marketing to those younger than 18 years of age, has for decades targeted marketing and promotional activities to young adults.”

Ninety percent of adult smokers began before the age of 21, according to an American Lung Association study.