Smoking is really bad for you. Most people know that. Even smokers think smoking is bad for one’s health. But most people don’t know just how bad it is.
More people in the United States die every year from smoking than from alcohol, illegal drug use, car accidents, suicides and murders combined.
Cigarette smoking costs an estimated USD 240 billion annually in health care costs, which harm not only smokers but also nonsmokers, communities and the economy.
Smoking is the top preventable cause of death and disease in the US and worldwide. The number of smokers in the US has declined from 41% in 1944 to 11% in 2024. However, over 25 million Americans still smoke.
This drop is partly the result of many smoking laws enacted in the past 50 years. They include national bans on cigarette advertising on television and radio (1971), smoking on commercial flights (2000), sale of fruit- or candy-flavoured cigarettes (2009), and sale of cigarettes to people ages 18 to 20 (2019).
New policies might seem as strange or unfamiliar as these measures did at the time. One potentially transformative idea- creating a tobacco-free generation- would build on these past laws. It would phase out smoking by banning it permanently for anyone born after a specific date.
For example, a law could make it illegal for anyone under 21 to ever buy cigarettes, whereas people age 21 or older at the time would not be affected.
The focus would be on tobacco sales, which already require age verification in the US, not on criminalising tobacco use.
As a psychological scientist, I have studied for decades how people think about smoking.
In my view, the key obstacle to creating future generations of nonsmokers is that people do not fully understand how dangerous smoking is and do not realise the formidable influence of the tobacco industry.
Creating a tobacco-free generation
The idea of creating a tobacco-free generation was first proposed by health researchers in 2010. In 2021, the town of Brookline, Massachusetts, became the first US community to adopt it.
Brookline’s ordinance prohibits tobacco and vape sales to anyone born on or after Jan. 1, 2000. It has survived a legal challenge and has been emulated in 22 more Massachusetts towns.
Why do people underestimate the harm from cigarettes: It is hard to visualise what exactly it means that 480,000 people in the US die from smoking every year, or that each cigarette that you smoke shortens your life by 20 minutes.
It is also easy to feel optimistically biased about one’s personal risk as a smoker and believe that others are more likely to become addicted or die prematurely. Studies show that nonsmokers, former smokers and current smokers underestimate smoking risks.
One likely reason is messaging by the tobacco industry, which claimed for decades that cigarettes were safe, even though tobacco industry scientists knew as early as 1953 that smoking caused lung cancer.
Another factor is the glamorisation of cigarettes in movies.
Fully half of the top films released in 2024 showed tobacco imagery, typically of cigarettes.
Research shows that adolescents and young adults who watch smoking in movies are more interested in taking up smoking.
Finally, smoking deaths may seem to be unremarkable because some of the illnesses that cigarette smoking causes, such as heart disease or cancer, are commonplace. And unlike deaths from drug overdoses, we do not always see the consequences of a lifetime of smoking.
What about freedom of choice?
A common argument against laws that regulate personal choices, such as whether to smoke or wear seat belts, is that people prize their autonomy and don’t like governments telling them how to live.
This isn’t a new challenge for public health policies, which often restrict private citizens’ freedom to do as they wish.
People can be persuaded that community action should trump individual choice if a behaviour, such as smoking cigarettes or driving while drunk, harms others who don’t engage in it.
Arguments against generational smoking laws: The tobacco industry’s attempts to undermine tobacco health policies are well-documented and follow a predictable pattern.
For example, when the UK government considered a generational smoking policy in 2023, tobacco companies and their supporters argued that smoking was a minor problem, that individuals should be responsible for their own choices, and that a nationwide ban would lead to illegal behaviour or hurt business profits.
The tobacco industry’s harm reduction approach frames e-cigarettes, also known as vapes, as a way to create a smoke-free future by transitioning smokers to other nicotine products. (The Conversation)
