Tobacco 21: A Strategy to Protect Young Hearts in South Dakota

Guest Author: Megan Myers,  Government Relations Director, South Dakota American Heart Association, Midwest Affiliate

Guest Author: Megan Myers, Government Relations Director, South Dakota American Heart Association, Midwest Affiliate

Heart disease is the No. 1 killer of South Dakotans, with more than 1,800 deaths annually. And since tobacco use is the No. 1 risk factor for developing heart disease in young men and women, the American Heart Association is supportive of a variety of policies to keep our youth from getting hooked on tobacco such as Tobacco 21.

By breaking the supply chain of how kids under 18 get tobacco products, raising the sales age for tobacco products from 18 to 21 could make a big difference in keeping kids from getting hooked for life and developing the chronic diseases that come along with long-term tobacco use. Ninety percent of people who buy tobacco for minors are between ages 18–20.

People who have not used tobacco by age 21 are unlikely to ever start. A policy to increase the tobacco sales age to 21 works gradually over time to reduce the rate of when people start to use tobacco and the prevalence of tobacco use. Reductions will be small initially and will grow over time, and as a result, there will be little short-term effect on tobacco sales revenue.

If every state raised the age to 21, we could reduce the nationwide smoking rate by about 12 percent and smoking-related deaths by 10 percent. That translates into 223,000 fewer premature deaths, 50,000 fewer deaths from lung cancer, and 4.2 million fewer years of life lost. Each year in South Dakota alone, we spend $373 million in health care expenditures and another $282.5 million in lost productivity related to tobacco use.

We are coming at this from a perspective of health and prevention – when we know better, we do better. It wasn’t that long ago that the U.S. military put packs of cigarettes in C-rations. Now thousands of our veterans suffer from tobacco-related illnesses such as heart disease, cancer, COPD and more.

Simply put - tobacco use is not a rite of passage or a sign of adulthood. It is a gateway to a lifetime of addiction to the only legally available over-the-counter product in the United States that, when "used as directed," can kill you and often those around you.

Five states and nearly 300 municipalities have Tobacco 21 in place. South Dakota has the opportunity to be a nationwide leader on this policy that will save thousands of lives and millions of dollars.

Unfortunately, our state legislature recently defeated a bill that would have made Tobacco 21 law, but this is a long-term strategy and our work continues. For more information and to get involved with our coalition of partners working to enact tobacco prevention and control policy, check out our American Heart Association South Dakota Facebook page or contact me at