Massachusetts towns ban nicotine for a generation. Public health win or overreach?
| Brookline and Chelsea, Mass.
If you were born after 2003, you will never be old enough to buy cigarettes in Chelsea, Massachusetts. And as of Jan. 1, in at least eight other towns.
Municipalities in the Bay State are determined to create a 鈥渘icotine-free generation.鈥� And three Massachusetts legislators recently announced they plan to file a statewide version of the bill in 2025.
The regulations have set up an ideological battle, as local officials and their constituents wrestle with how far governments should go to protect public health. Proponents see such rules as a way to save lives and eliminate a major societal ill. Detractors see a Prohibition-style overreach that undermines personal freedom and threatens small businesses.
Why We Wrote This
A story focused onWho is responsible for the health of young people? Tobacco bans in Massachusetts towns have residents weighing public health concerns against individual freedoms and considering what it means to have a 鈥渘icotine-free generation.鈥�
Similar attempts to sunset tobacco are picking up steam worldwide. The United Kingdom to ban cigarette sales for anyone born after 2008. Earlier this year, members of South Australia鈥檚 parliament introduced a that would do the same for those born after 2006.
It鈥檚 not yet clear if these regulations will spread elsewhere in the United States. But in Massachusetts, which has a long history of public health innovation, supporters seem optimistic.
鈥淲e鈥檙e at a level of readiness that is really the envy of most other states,鈥� says Mark Gottlieb, a lawyer who runs Northeastern University鈥檚 Public Health Advocacy Institute. 鈥淭his is a really good place to see where this policy can go.鈥�
In 2020, Brookline, Massachusetts, became the only place in the world to enforce a nicotine-free generation bylaw. Anyone born on or after Jan. 1, 2000, will never be able to buy cigarettes there, according to the rule co-sponsored by Anthony Ishak, a pharmacist, and Katharine Silbaugh, a law professor. A group of convenience stores sued, arguing that the rule was unconstitutional and conflicted with state law.
In March, the Massachusetts Supreme Judicial Court that lawsuit, ruling that municipalities have the authority to regulate tobacco as they see fit. Since then, 11 other places have passed bans, including Concord, Reading, Needham, and Malden.
Adult in the U.S. have declined precipitously in the past six decades, falling from 42% in 1965 to 12% in 2022. Youth rates have hovered in the single digits since 2017.
Yet tobacco remains the in the U.S. Cigarette smoke kills some 480,000 Americans each year, according to the Centers for Disease Control and Prevention. That accounts for nearly 20% of all U.S. deaths annually, and outstrips deaths from opioids, gun violence, suicides, and car accidents combined.
What about personal choice?
Todd Taylor, a Chelsea city councilor, says he鈥檚 glad he quit smoking 18 years ago. He encourages policies like community outreach and education to cut smoking rates. Yet he thinks nicotine-free generation bans infringe on choices that should belong to individuals 鈥� or, at a minimum, elected officials.
鈥淭hese decisions should not be taken up by local boards of health,鈥� he said at a Nov. 19 board of health hearing in Chelsea. 鈥淭his belongs in the legislature.鈥�
Local boards of health, which can be either elected or appointed, have largely led the charge in enacting generational tobacco bans.
鈥淲hether you鈥檙e in favor or opposed, it deserves a little bit more discussion,鈥� says Peter Brennan, executive director of the New England Convenience Store and Energy Marketers Association. 鈥淧eople are tired of the government 鈥� in this case, a local, unelected board of health 鈥� telling them what they can and can鈥檛 do.鈥�
Yet proponents see banning nicotine as a boon for personal freedom. In interviews and at public hearings, they argue that addiction, not regulation, is a threat to freedom of choice.
In a 2022 survey, 53% of smokers had tried to quit in the past year. Only 9% succeeded.
鈥淎dult choice was taken away by addiction,鈥� says Chris Bostic, policy director at anti-tobacco group Action on Smoking and Health. 鈥淎nd almost all [people who smoke] became addicted as children.鈥�
The vast majority 鈥� about 87% 鈥� of people who smoke have their first cigarette .
Concerns about stepping on individual freedoms in the name of the greater good is a perennial tension for public health officials. In some ways, today鈥檚 debates about nicotine recall those that roiled the country during the COVID-19 pandemic, when cities imposed lockdowns and mask mandates. Then, as now, detractors sharply criticized government intervention that supporters said was necessary to save lives.
鈥淢any Americans have died for individual freedom. Some things may not be good for you, and other things may be worse, but it鈥檚 up to adults to have that freedom,鈥� Stephen Helfer, co-founder of the group Cambridge Citizens for Smokers鈥� Rights, says at Chelsea鈥檚 hearing.
Massachusetts is also one of 24 states, along with D.C., that have legalized recreational marijuana. That approach stands in contrast with these cities鈥� hard line on tobacco.
Mr. Bostic says that鈥檚 comparing apples to oranges. 鈥淲e can鈥檛 equate them just because the main way of using them is to light them on fire,鈥� he says. 鈥淲e can at least address the product that by far kills the most people.鈥�
Not all Massachusetts health experts agree that generational bans are the way forward. Vaughan Rees, director of Harvard University鈥檚 Center for Global Tobacco Control, cites doubts that the rules will reach marginalized groups.
鈥淚 don鈥檛 see any evidence or reason to assume that a generational-style law is going to support or promote advantages in some of the marginalized populations that we鈥檝e been talking about,鈥� Dr. Rees says. He points specifically to people who use illicit drugs, who also tend to smoke tobacco . 鈥淚mposing yet another regulatory burden on marginalized communities may not yield the effects that we hope it might.鈥�
Mike Siegel, a professor at Tufts University School of Medicine, agrees that such a law is unlikely to stop people who want to smoke. Yet he supports a ban, arguing that it may change social norms among young people.
鈥淚t鈥檚 not just 鈥楧on鈥檛 smoke because it鈥檚 harmful.鈥� It鈥檚, 鈥榃e have declared you to be a smoke-free generation,鈥欌�� Dr. Siegel says. 鈥淭hat creates a tremendous disincentive 鈥� because, essentially, if you smoke, you鈥檙e rallying against your generation.鈥�
This isn鈥檛 the first time that the Bay State has found itself at the cutting edge of tobacco control. The Commonwealth was also the first to restrict the sale of all flavored tobacco products, and to ban tobacco sales in health-care establishments. At 10.4%, Massachusetts has smoking rates in the country.
Additionally, Massachusetts health boards are powerful compared with those in other states, according to Mr. Gottlieb. Their regulations carry the same legal weight as those enacted by local lawmaking bodies, giving them broad regulatory discretion.
In Brookline, Mr. Ishak sees phasing out tobacco as building on that legal history. 鈥淗istorically, Massachusetts has been at the forefront of tobacco legislation,鈥� he says. 鈥淚t was firm territory to be able to try something like this.鈥�
Mr. Ishak鈥檚 father took up smoking when he was young. His son says the habit almost killed him before he was able to leave it behind for good.
He recounts his father鈥檚 story at a Chelsea鈥檚 public hearing, held at a middle school.
The health board was convinced. The bylaw passed unanimously on Dec. 10.
鈥淚鈥檓 paying the price鈥�
Under most nicotine-free generation laws, those who have already turned 21 can still buy tobacco products. Ms. Silbaugh believes this is a sensitive approach to regulating nicotine while acknowledging that some Americans have a dependency on it.
鈥淢ost adults who use nicotine or tobacco products don鈥檛 want to be,鈥� she says. A 2022 found that 68% of people who smoke want to quit. 鈥淪o the question is, how could we regulate it to be compassionate toward people who need it, but without adding to their ranks?鈥�
In Ms. Silbaugh鈥檚 eyes, it鈥檚 also compassionate toward retailers. Rather than take products off shelves immediately, phased bans shrink retailers鈥� customer base over decades.
But in Brookline, at least one business is feeling the squeeze. Waseem Heriki says his father鈥檚 convenience store is doing 鈥渙ne-third as well as it used to.鈥�
鈥淚鈥檓 hoping that the law gets changed,鈥� Mr. Heriki adds. 鈥淚鈥檓 paying the price.鈥�
Previous tobacco control initiatives also started small. In 2005, the board of health in Needham, Massachusetts, voted to make the town to raise its tobacco purchasing age to 21 鈥� a policy that became federal law over a decade later.
Yet detractors say that health boards鈥� reliance on expert opinions creates a blind spot to constituents鈥� wants. 鈥淭hese boards of health are very biased in favor of the proposal, and they鈥檙e biased in favor of their public health professionals that they interact with,鈥� Mr. Brennan, of the convenience stores association, says.
Will generational bans work?
It鈥檚 too early to tell how successful these policies will be. Because they鈥檝e never been tried before with tobacco, research is scant. Questions remain about whether they could contribute to the creation of an illicit market, as happened when Massachusetts tobacco products.
Mr. Gottlieb acknowledges those concerns 鈥� though he maintains that this is different. 鈥淚n the case of the flavors, you have strong existing demand for these products, and then they were taken away,鈥� he says. 鈥淗ere, you鈥檙e not really taking anything away from somebody where there鈥檚 a strong demand.鈥�
It鈥檚 possible, however, that people who can鈥檛 buy tobacco in one town will simply travel to another where they can.
Supporters argue that it鈥檚 what鈥檚 local that matters. When Needham raised its buying age in 2005, smoking rates in the town fell at triple the rate of its neighbors whose age remained 18, according to in the New England Journal of Medicine.
In Chelsea, where the smoking rate is聽聽the state average, young public hearing attendees seemed to revel in the idea that theirs could be the first generation for whom tobacco is not an option. Of the four who spoke, all were in favor of the ban.
鈥淭his law challenges the prevailing notion that tobacco is a rite of passage,鈥� Bhavika Kalia says. She鈥檚 a high school student from nearby Somerville, which is also mulling a ban. 鈥淚t is about taking bold action to protect the well-being of those who will lead our communities tomorrow.鈥�
