Testimony by Charleta Guillory, MD, MPH, FAAP
House Bill 1908 by Rep. John Zerwas, MD
March 28, 2017
Thank you, Chair Price and members, for the opportunity to speak to you today in favor of House Bill 1908. My name is Dr. Charleta Guillory, and I am speaking today on behalf of the March of Dimes, Texas Pediatric Society, and Texas Medical Association (TMA), representing more than 50,000 physicians and volunteers in Texas. I am from Houston, where I’m an associate professor of pediatrics at Baylor College of Medicine, attending neonatologist and director of the Neonatal-Perinatal Public Health Program at Texas Children’s Hospital, and a Robert Wood Johnson health policy and congressional fellow. In addition, I am a member and past chair of the State Advocacy and Government Affairs Committee for the March of Dimes, co-chair of the Fetus and Newborn Committee for Texas Pediatric Society, and a consultant on TMA’s Committee on Reproductive, Women’s, and Perinatal Health.
As you are aware, the minimum age to buy tobacco is 18 years old. On average, 90 percent of adult smokers begin smoking during their teenage years, and 95 percent of users begin before their 21st birthday. By raising the minimum age required to buy tobacco products and helping delay — or prevent altogether — the start of tobacco use, we can significantly improve public health outcomes for the patients I care and advocate for: women, children, and infants.
Nationwide, an average of one in every 10 pregnant women smokes, accounting for half a million births per year. For expecting mothers, tobacco use during pregnancy increases the risk of premature delivery and directly affects fetal growth. According to the 2014 surgeon general’s report, in the last 50 years, 10,000 babies have died from sudden infant death syndrome or complications of prematurity, low birthweight, and other conditions resulting from parental smoking. An estimated $122 million per year is spent nationally on neonatal health care costs attributable to maternal smoking.
Prenatal and postnatal environmental smoke exposure have proven devastating for both the developing fetus and young children. For example, exposure to tobacco smoke in-utero or in the environment after birth has been linked to increased incidence of respiratory infections, ear infections, and behavioral disorders. Children and infants who are exposed to prenatal maternal smoking and in-home environmental tobacco smoke have a high incidence of severe asthma.
My primary care colleagues will tell you children and infants exposed to tobacco smoke often are hospitalized longer for asthma and respiratory infections compared with children who are not exposed to tobacco. This is why they counsel teens and their parents in a well-child visit to avoid tobacco use at all costs. They describe the very real situation where 19- to 21-year-old peers often buy a teen his or her very first cigarette.
Failure to decrease the use of tobacco and environmental tobacco exposure will cause continued poor health outcomes for mothers, infants, and children. Because the vast majority of smokers begin using tobacco in their teenage years, this bill targets those under the age of 21 with the goal of decreasing the prevalence of tobacco use among adolescents.
The March of Dimes, Texas Pediatric Society, and Texas Medical Association support legislative and regulatory action to reduce exposure to tobacco smoke among pregnant women and infants. We ask that you support HB 1908 and the Texas-21 initiative, and look forward to working with you to ensure that all babies are given the best chance at a healthy start in life.
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