The Somerville, Mass., Board of Health recently held a public hearing on a proposal to implement a “Nicotine-Free Generation” (NFG) policy. It would ban the sale of tobacco and vapor products to anyone born after a certain date.
Though the board unanimously approved the measure – joining a growing list of localities enacting increasingly aggressive restrictions – the hearing exposed a troubling mix of alarmism, misinformation, and misplaced priorities. Most importantly, the policy does little to address the real crisis facing young people in Massachusetts: a worsening mental health epidemic that’s leading some toward far more dangerous substances.
The hearing, dominated by public health advocates and activists, was heavy on emotion and light on evidence. Pediatrician Dr. Jonathan Winickoff falsely equated nicotine addiction to that of opioids like heroin and fentanyl – a comparison not grounded in scientific fact. A handful of 10th-grade students, well below the state and national tobacco purchase age of 21, offered anecdotal stories about classmates vaping. Others repeated familiar narratives funded by anti-tobacco organizations, alleging that the industry targets youth with flavored products.
What those arguments ignore is that Massachusetts already has some of the strictest tobacco laws in the country. In 2003, Needham became the first U.S. municipality to raise the tobacco purchase age to 21. A statewide T-21 law followed in 2018 under Gov. Charlie Baker, and later that year, President Donald Trump signed national T-21 legislation. In December 2019, Massachusetts went even further by banning the sale of all flavored tobacco and vapor products, regardless of the buyer’s age – a policy that took effect in mid-2020.
With such sweeping restrictions already in place, it’s difficult to argue that additional regulations are necessary. If anything, more bans risk fueling illicit markets rather than reducing access. Moreover, data shows youth nicotine use in Massachusetts is already plummeting. The 2023 Massachusetts Youth Health Survey found that only 12.1 percent of teens had ever smoked a cigarette, and just 30.4 percent had ever tried an e-cigarette. Current use, defined as any use in the past 30 days, was only 16 percent. Youth vaping has dropped by 50 percent since 2019 and continued declining through 2023.
National data backs this up. According to the CDC’s Youth Risk Behavior Survey (YRBS), only 3.4 percent of Massachusetts high school students reported current cigarette use in 2023, and 18.3 percent reported current vaping. Since 2003, teen smoking in the commonwealth has declined by nearly 84 percent. By World Health Organization standards, a population is considered “smoke-free” when smoking prevalence is below 5 percent. By that measure, Massachusetts teens already meet the definition.
Despite this undeniable progress, lawmakers continue to miss the bigger issue: why young people are turning to nicotine in the first place. The CDC reports the most common reasons for teen vaping are to cope with anxiety, depression, and stress. Yet policies like T-21 laws, flavor bans, and now the NFG, do nothing to address those underlying mental health struggles – struggles that are only growing worse.
According to the 2023 YRBS, 34 percent of Massachusetts high school students reported persistent feelings of sadness or hopelessness, and 12.3 percent had made a suicide plan. Over the past decade, feelings of hopelessness have risen by nearly 57 percent and suicide planning by almost 12 percent. These numbers should be grabbing the attention of lawmakers and public health agencies.
Even more concerning is the rise in youth use of far more dangerous substances. Between 2019 and 2021, drug overdose deaths among U.S. teens aged 14 to 18 rose by a staggering 94 percent. Meanwhile, during that same period, smoking and vaping among high schoolers dropped sharply – by over 67 percent and nearly 59 percent, respectively. These trends suggest teens are not only using nicotine less – they may be turning to more lethal alternatives in response to mental health challenges.
The conflation of nicotine with opioids like heroin is not only scientifically inaccurate, but potentially harmful. Nicotine withdrawal, while uncomfortable, typically involves symptoms such as irritability, restlessness, and increased appetite. In contrast, opioid withdrawal can include severe muscle spasms, vomiting, elevated blood pressure, and long-term psychological distress. Suggesting the two are equivalent distorts the public conversation and undermines the urgency of addressing the opioid crisis.
Somerville and other Massachusetts communities should reconsider the rush to enact NFG policies. Traditional tobacco use among youth is nearly nonexistent, and current laws are among the strictest in the nation. Instead of expanding bans on already-declining behaviors, public health officials should prioritize addressing the mental health crisis that’s actually driving risky behavior. We won’t solve these challenges with more prohibitions. We’ll only make progress by acknowledging—and addressing—the root causes.
