In the fight against tobacco use, the American Lung Association is calling on Idaho leaders to raise the legal age, increase taxes and make more areas "smoke-free."

In December 2019, then-President Donald Trump and the Food and Drug Administration approved raising the minimum age for retailers to sell tobacco products to anyone under 21. A subsequent bill in the Idaho legislature failed the following February in a 22-10 vote on the Senate floor.

"The Legislature indeed failed to add it to Idaho law, but the federal rule does supersede that," the Boise-based American Lung Association Director of Health Promotions Heather Kimmel said. "It's still important to increase Idaho's sale age in rule books because it eases confusion and creates a unified understanding for Idaho retailers."

Republican Sen. Mary Souza from Coeur d'Alene was one of the Health and Welfare Committee members last year when the rule came before the Senate. She stood by her decision against the law and noted that the Legislature did make progress on tobacco control. 

"It was already a federal requirement, and I just thought it was unnecessary because the federal government had already made the law," Souza said. "Last year, we also required vaping to be under the 21 rule. That was a new bill for Idaho. There had been no regulation of vaping in our history."

An essential step for reducing nicotine use in Idaho last year, Kimmel said, was adding electronic cigarettes — commonly coined e-cigs or vapes — into the state definition of tobacco through House Bill 538. 

"Tobacco and cigarettes are an important component to an individual health concern, but the rallying point right now is teen and young adults vaping because that is certainly taking off as a trend," Rep. Paul Amador, R-Coeur d'Alene, said. "I can't imagine we would completely ban electronic or tobacco cigarettes, but there are possibilities to make it more difficult to fall into the hands of young users."

House Bill 538 established parity, Kimmel said, or the "equality between traditional and electronic" cigarette users. 

People who sell electronic cigarettes are required to obtain a permit like tobacco retailers, Kimmel said. This change also requires e-cigarette sellers to participate in compliance checks to make sure they are not selling products to people younger than 21, he added.

In the 2020 CDC National Youth Tobacco Survey, disposable e-cigarette use data skyrocketed by 1,000% among high schoolers, from 2.4% to 26.5% and 400% in middle school users from 3% to 15.2%. Still, the NYTS reported vaping in the youth population is slowly decreasing, down from 27.5% in 2109 to 19.6% in high school-age smokers and 10.5% to 4.7% in middle school children.

To help influence younger users away from addiction, add e-cigarettes to tobacco tax regulations and raise the state tax closer to the national average. Compared to CDC data, Idaho's $. 57 tobacco tax is a little over half the national average rate of $1.01 per pack of 20 cigarettes and exempt electronic cigarettes. 

"We know that raging the price overall is one of the best ways to keep tobacco products out of the hands of youth," Kimmel said. "For every 10% increase, adult-use drops by 4%, and in youth, it drops by 7%, that's how big a difference price can make."

Increasing taxes is an uphill battle, Amador said, but because could be a future possibility based on the values Idahoans share. 

"We're a very conservative state, and generally, people are not keen on adding new taxes," he said. "That being said, in Idaho, we are more favorable to what I call a 'sin-tax' based on our cultural and religious foundation. I think we could be more willing to put e-cigarettes in a 'sin-tax,' but it's difficult talking about adding any tax."

Other policies the ALA hopes to inspire in Idaho is creating more "smoke-free air" space, banning flavored products, and increasing the state funding tobacco campaigns. There is a broad coalition of ALA workers and supporters attempting to start the conversation of greater tobacco regulation in Idaho, Kimmel said.

"We would like to see progressive parity, and that conversation is something we are starting to have with legislators at the local level," she said. "There are a couple of areas where we are well-positioned to make important policies and programs that will help an enormous number of Idahoans."