In February, Trenton City Council voted to raise the minimum legal age to purchase cigarettes and any other tobacco-related products in the City of Trenton. What role did the Trenton Health Team play in making that change happen?

We received a five-year, $2.5 million grant from Trinity Health in 2016 to address population health issues. The Tobacco 21 initiative was recognized as a priority for Trinity Health, St. Francis Medical Center in Trenton, an affiliate of Trinity Health, and for us. We also worked with other partners, including the Department of Health & Human Services and the Health Officer for the City of Trenton. It was a true public and private sector collaboration. We took the opportunity to engage with different stakeholders in the state, as well as an array of national partners. We also reached out to the city of Princeton, which passed its own Tobacco 21 ordinance. They were very helpful to us.

What were your arguments for seeking the ordinance?

Promoting healthy lifestyles and behavior and preventing chronic disease are all important to us as an organization. Along with childhood obesity, we have identified tobacco prevention and cessation as a major priority. Tobacco is the leading cause of preventable death not just in the U.S., but also around the world. There was an attempt to adopt Tobacco 21 on the state level, but Gov. Christie pocket-vetoed the bill. So municipalities are doing this on the local level. We explained that 90 percent of adult smokers started smoking before leaving their teen years. The teenage brain is not fully developed, especially the parts of the brain responsible for decision-making. We knew we had the potential to save thousands of preventable deaths from the effects of smoking.

What arguments did you hear against passage?

The arguments against the ordinance were varied. The first time around, the measure was passed by 4-2 with one council member abstaining. The second time around, however, it passed 6-1. The one council member who voted against the ordinance was a smoker. Although 75 percent of people who smoke support the T21 policy, she argued that you should have the right to start smoking when you’re an adult and that there are already too many policies that limit individual rights. We heard people say that if you are old enough to enlist in the military you should be able to buy a pack of cigarettes. We also heard that the ordinance would impact small stores in the city.

How did you counter those arguments?

As for the military argument, the military increasingly supports Tobacco 21 and has voluntarily adopted the standards on some of its bases. Military-civilian partnerships have been formed to advocate for Tobacco 21. The military knows that tobacco limits a person’s preparedness and ability to recover from injuries or wounds. We found that the impact on stores is minimal and sales to the under-21-age group amount to two percent of tobacco sales. We also reached out to Latino Merchants Association and received their buy-in.

Trenton participates in the Mayors Wellness Campaign and works with the Trenton Health Team and the Quality Institute to improve the health of the city. Will the process of passing this ordinance help other efforts to improve the health of the Trenton community?

 Absolutely. Through the collaboration created to pass Tobacco 21, we are now working with partners on other initiatives, such as Complete Streets, which is an effort to create streets safe for everyone: pedestrians, bicyclists, motorists and transit riders of all ages and abilities. It’s about making our streets safe to walk to shops, bicycle to work, etc. We are working to create and plan a habitable downtown. We will follow up on our smoking efforts with a survey we will give to middle and high school students now and in five years to see if the policy has made a difference.