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Vitale says making it more difficult to buy cigarettes "will help prevent our youth from becoming lifelong smokers and suffering the long-term effects of the habit." Hawaii and California are the only other states where the smoking age is 21.

It wasnt the hardest thing Ive ever been throughits not as hard as childhood, for examplebut its harder than most things adults have to deal with

Increase community ability to engage in policy change

Using New Zealand as a case example, in the early 1980s the excess lung cancer and COPD mortality in smokers (SRDs) was notably greater in men than women, but by the late 2000s SRDs in women had increased to be similar to men