Lifestyle
Tobacco is still one of the world’s top killers – here are the key obstacles to enacting generational smoking bans
Marie Helweg-Larsen, Dickinson College
Smoking is really bad for you. Most people know that. Even smokers think smoking is bad for one’s health. But most people don’t know just how bad it is.
More people in the United States die every year from smoking than from alcohol, illegal drug use, car accidents, suicides and murders combined. Cigarette smoking costs an estimated US$240 billion annually in health care costs, which harm not only smokers but also nonsmokers, communities and the economy. Smoking is the top preventable cause of death and disease in the U.S. and worldwide.
The number of smokers in the U.S. has declined from 41% in 1944 to 11% in 2024. However, over 25 million Americans still smoke.
This drop is partly the result of many smoking laws enacted in the past 50 years. They include national bans on cigarette advertising on television and radio (1971), smoking on commercial flights (2000), sale of fruit- or candy-flavored cigarettes (2009), and sale of cigarettes to people ages 18 to 20 (2019). New policies might seem as strange or unfamiliar as these measures did at the time.
One potentially transformative idea – creating a tobacco-free generation – would build on these past laws. It would phase out smoking by banning it permanently for anyone born after a specific date. For example, a law could make it illegal for anyone under 21 to ever buy cigarettes, whereas people age 21 or older at the time would not be affected. The focus would be on tobacco sales, which already require age verification in the U.S., not on criminalizing tobacco use.
As a psychological scientist, I have studied for decades how people think about smoking. In my view, the key obstacle to creating future generations of nonsmokers is that people do not fully understand how dangerous smoking is and do not realize the formidable influence of the tobacco industry.
Creating a tobacco-free generation
The idea of creating a tobacco-free generation was first proposed by health researchers in 2010. In 2021 the town of Brookline, Massachusetts, became the first U.S. community to adopt it. Brookline’s ordinance prohibits tobacco and vape sales to anyone born on or after Jan. 1, 2000. It has survived a legal challenge and has been emulated in 22 more Massachusetts towns.
As of early 2026, Hawaii and Massachusetts are considering statewide tobacco-free generation bills. Abroad, the Maldives enacted the first countrywide ban in 2025.
Similar proposals have faced pushback elsewhere. In New Zealand, a ban was adopted in 2022 but repealed in 2024. The United Kingdom is considering a similar bill after an earlier version was scrapped due to a snap election.
Why people underestimate harm from cigarettes
It is hard to visualize what exactly it means that 480,000 people in the U.S. die from smoking every year or that each cigarette that you smoke shortens your life by 20 minutes. It is also easy to feel optimistically biased about one’s personal risk as a smoker and believe that others are more likely to become addicted or die prematurely.
Studies show that nonsmokers, former smokers and current smokers underestimate smoking risks. One likely reason is messaging by the tobacco industry, which claimed for decades that cigarettes were safe, even though tobacco industry scientists knew as early as 1953 that smoking caused lung cancer.
Another factor is glamorization of cigarettes in movies. Fully half of the top films released in 2024 showed tobacco imagery, typically of cigarettes. Research shows that adolescents and young adults who watch smoking in movies are more interested in taking up smoking.
Finally, smoking deaths may seem to be unremarkable because some of the illnesses that cigarette smoking causes, such as heart disease or cancer, are commonplace. And unlike deaths from drug overdoses, we do not always see the consequences of a lifetime of smoking. https://www.youtube.com/embed/2mKyosQbFNY?wmode=transparent&start=0 Smoking imagery is widespread in popular culture and may be one driver of tobacco use, especially among young Americans.
What about freedom of choice?
A common argument against laws that regulate personal choices, such as whether to smoke or wear seat belts, is that people prize their autonomy and don’t like governments telling them how to live. This isn’t a new challenge for public health policies, which often restrict private citizens’ freedom to do as they wish.
People can be persuaded that community action should trump individual choice if a behavior, such as smoking cigarettes or driving while drunk, harms others who don’t engage in it. Many public health laws are designed to protect people who are innocent or vulnerable. For example, current smoking laws have been enacted in part to protect nonsmokers who are exposed to secondhand smoke, especially children. And smoking increases health care costs for everyone, not just smokers.
By preventing people in the U.S. who cannot legally buy cigarettes now from ever doing so, generational smoking bans balance the rights of current adult smokers against the major public health benefits of a phased smoking ban that will eventually end the smoking epidemic.
Arguments against generational smoking laws
The tobacco industry’s attempts to undermine tobacco health policies are well documented and follow a predictable pattern. For example, when the U.K. government considered a generational smoking policy in 2023, tobacco companies and their supporters argued that smoking was a minor problem, that individuals should be responsible for their own choices, and that a nationwide ban would lead to illegal behavior or hurt business profits.
In a 2025 study assessing how Belgian politicians viewed generational smoking bans, researchers heard similar arguments. Respondents across the political spectrum valued personal freedom and informed individual choice more highly than protecting children. The politicians also believed that young people could understand how smoking affected their health, and that raising awareness was more important than bans. These arguments aligned with tobacco industry positions.
However, research shows that young people hold many optimistic beliefs about smoking, especially with respect to the addictiveness of nicotine and the likelihood that they will avoid becoming lifelong smokers. Studies have also found that adolescents don’t know enough to make an informed choice to smoke. These findings matter because the tobacco industry routinely targets young people in an effort to create lifelong smokers.
The tobacco industry’s harm reduction approach frames e-cigarettes, also known as vapes, as a way to create a smoke-free future by transitioning smokers to other nicotine products. But research shows that the tobacco industry actively markets nicotine products such as vapes to young people to create a new generation of nicotine users.
Not a silver bullet
Curbing the use of an addictive product is challenging, and there are ways for young people to obtain cigarettes illegally, as they do now in places where cigarette buyers must be at least 21. Tactics include shopping at stores that don’t check IDs, having older friends buy cigarettes and purchasing cigarettes illegally online.
Tobacco-free generation policies aren’t a silver bullet. They work most effectively in conjunction with other measures, such as plain packaging; high prices; bans on displays, advertising and flavored products; smoking cessation support; and public health messages making clear that cigarettes are unsafe at any age.
Still, health experts and groups including the American Heart Association and the American College of Cardiology argue that creating a tobacco-free generation could dramatically reduce preventable deaths and secure a healthier future for today’s children and future generations. In my view, understanding the obstacles to change is a critical step toward achieving this goal.
Marie Helweg-Larsen, Professor of Psychology, Dickinson College
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Consumer Corner
Cold cities are the most ready for winter, with one exception. See where your city ranks
Cold cities? Every neighborhood has a mix of homeowners who approach seasonal home maintenance differently – there are the people who stay on schedule, and on the other end, the procrastinators. There are the dedicated DIYers, and those who have their favorite maintenance pro saved as a favorite contact in their phone. As it turns out, cities are no different. Some metropolitan areas keep their neighborhoods in tip-top shape, while others are a little more slow-going.
Cold cities are the most ready for winter, with one exception. See where your city ranks
(Sheeka Sanahori) Every neighborhood has a mix of homeowners who approach seasonal home maintenance differently – there are the people who stay on schedule, and on the other end, the procrastinators. There are the dedicated DIYers, and those who have their favorite maintenance pro saved as a favorite contact in their phone. As it turns out, cities are no different. Some metropolitan areas keep their neighborhoods in tip-top shape, while others are a little more slow-going.
New data from home services company Angi, covering fall maintenance activity in August, reveals which U.S. metropolitan areas are the most proactive with fall maintenance. Washington, D.C., tops the ranking with the strongest demand for fall maintenance in the country, followed by Columbus, Ohio, and Milwaukee, Wisconsin. Northern cities dominate the rest of the list.
Cleveland, Ohio, and Albany-Schenectady-Troy, New York, round out the top five. Cold-weather markets dominate the ranking, accounting for eight of the 10 most-prepared metros. Rochester, New York; Charlotte, North Carolina; Chicago; Indianapolis; and Pittsburgh complete the top 10.
Least fall-ready metros
Fewer than 1 in 5 American cities is prepping for fall at an above-average rate. Among the 66 metros that recorded at least 100 fall maintenance service requests during the analysis period, Los Angeles had the lowest level of per-capita activity, followed by Oklahoma City and Riverside, California. California accounts for four of the bottom 10 markets, with Los Angeles, Riverside, San Diego and San Francisco all appearing on the list. These metros historically don’t experience the colder winter climates of the Northeast and Midwest, making fall maintenance less of an imperative.
Grand Rapids, Michigan, stands out as the only clearly cold-weather metro among the 10 least-prepared large metros. The New York City metro, which includes Newark and Jersey City, ranked just outside the 10 least-prepared large metros, coming in at number 11. Other New York state metros, including Syracuse, Rochester and the Albany metro area, were on the most prepared list.
Homeowners are choosing upkeep over upgrades
Sixty-three percent of homeowners who have recently hired a professional completed maintenance work, and 58% completed repairs. Although they may be waiting to do that dream kitchen or bath renovation, they’re focusing for now on the maintenance that keeps their homes in order.
The most common fall maintenance projects focus on outdoor upkeep. Nationally, tree trimming was the most popular, followed by lawn and yard waste cleanup and shrub care.
What homeowners should do now
When tackling a home maintenance list, start at the top of the home by inspecting the roof and gutters. Look for loose or damaged shingles, and make sure gutters are debris-free. It’s also a good idea to ensure downspouts direct water far away from the foundation. Homeowners should inspect these areas from the ground or hire a professional if the work requires climbing or feels unsafe.
Next, check for drafts around the windows and doors. Replacing worn weatherstripping and damaged caulk in the fall can prevent warm air from escaping once the heat comes back on. Homeowners should also inspect their HVAC filters and have the heating system checked before the temperatures drop.
Every home’s maintenance needs will vary, depending on the age and condition of the house and where it’s located. Whether homeowners hire a professional or safely address small issues, making the fixes can prevent larger and more expensive problems later.
The ranking: Metros from most to least prepared
America’s 10 Most Fall-Prepared Metros
1. Washington, D.C.
2. Columbus, Ohio
3. Milwaukee, Wisconsin
4. Cleveland, Ohio
5. Albany-Schenectady-Troy, New York
6. Rochester, New York
7. Charlotte, North Carolina
8. Chicago, Illinois
9. Indianapolis, Indiana
10. Pittsburgh, Pennsylvania
10 Metros With the Most Opportunity to Get Fall-Ready
1. Los Angeles, California
2. Oklahoma City, Oklahoma
3. Riverside, California
4. Miami, Florida
5. San Diego, California
6. Houston, Texas
7. Grand Rapids, Michigan
8. San Francisco, California
9. Austin, Texas
10. Memphis, Tennessee
Methodology
The rankings are based on fall maintenance activity recorded on Angi during August 2026. Projects included yard cleanup, winterization, roofing and gutters, heating systems, water and drainage, outdoor plumbing, fireplaces and chimneys, pest prevention, and snow and storm preparation. U.S. metropolitan areas were ranked by activity per 100,000 residents using 2020 U.S. Census population data. To qualify for the least-prepared ranking, metros were required to have at least five service requests or jobs during the analysis period. The rankings reflect activity on Angi’s platform and are not a complete measure of all home-maintenance activity within each metro. These rankings reflect activity observed on Angi’s platform and should not be interpreted as a complete measure of all home-maintenance behavior within a metro area.
Photo courtesy of Shutterstock
SOURCE:
Angi
College Life
Is College Worth It? New U.S. News Rankings Put More Weight on What Graduates Earn
Is college worth it? MIT has taken the No. 1 spot in the 2027 U.S. News Best Colleges rankings, ending Princeton’s 15-year run. But a new Earnings by Major metric could be even more important for families asking whether college is worth the investment.
For millions of students and families, choosing a college increasingly comes down to a basic question: Is college worth it?
The latest U.S. News & World Report Best Colleges rankings are attempting to provide another piece of information to help answer that question.
The 2027 rankings place the Massachusetts Institute of Technology (MIT) at No. 1 among National Universities, ending Princeton University’s 15-year run at the top. But perhaps the bigger story for prospective students isn’t which university occupies the No. 1 position.
It’s a significant change in how U.S. News measures the value of attending college.
For the first time, the rankings include an Earnings by Major factor designed to examine what graduates earn after leaving school — and to compare those earnings with graduates who studied the same subjects elsewhere.
Is College Worth It? U.S. News Looks Beyond Graduation
College has traditionally been promoted as an investment in a person’s future. But as families confront tuition, housing expenses and the possibility of student debt, simply earning a degree may no longer be enough information when deciding where — or whether — to attend.
Students increasingly want to know what happens after graduation.
The new U.S. News Earnings by Major metric examines graduate earnings four years after graduation using data from the U.S. Department of Education’s College Scorecard.
Importantly, the system doesn’t simply compare the average salary of graduates from one university with another.
Instead, earnings are compared within specific academic disciplines.
That distinction matters.
A university graduating large numbers of engineers, computer scientists or students entering other relatively high-paying occupations could otherwise appear to produce stronger financial outcomes simply because of the subjects its students choose to study.
Comparing graduates within similar fields is intended to provide a clearer picture of how graduates from different institutions fare financially.
From Student Debt to Graduate Earnings
The new Earnings by Major metric replaces the Graduate Indebtedness factor previously used by U.S. News.
That represents an important shift in perspective.
Instead of focusing primarily on how much debt students accumulate, the new measure looks at one aspect of what students may receive financially from their education after entering the workforce.
The metric examines employed federal financial aid recipients whose highest degree is a bachelor’s degree.
According to U.S. News, the approach is intended to reduce the influence of family financial advantages and provide a better indication of the economic value institutions may contribute to graduates.
That doesn’t mean earnings alone determine whether a college education is worthwhile.
But for a student potentially investing tens of thousands of dollars — and several years of their life — knowing how graduates in a particular major perform economically can be an important part of the decision.
MIT Takes the No. 1 Spot
Against that changing methodology, MIT moved into the No. 1 position among National Universities in the 2027 rankings.
The top three are:
- Massachusetts Institute of Technology
- Princeton University
- Harvard University
Princeton’s move to second place ends a run at No. 1 that began with the 2012 edition of the rankings.
Among National Liberal Arts Colleges, Williams College remained No. 1, followed by Amherst College at No. 2. Bowdoin College, Claremont McKenna College, Pomona College and Swarthmore College tied for third.
Nearly 1,700 institutions were evaluated in the 2027 edition.
Outcomes Are Becoming a Bigger Part of the Equation
The addition of graduate earnings is part of a broader emphasis on student outcomes in the U.S. News methodology.
U.S. News says outcomes now account for more than half of a school’s total score.
Institutions can be evaluated using as many as 17 weighted measures, including graduation and retention rates, social mobility for lower-income students, post-graduate earnings, faculty resources and academic peer assessments.
The shift reflects a changing conversation surrounding higher education.
For generations, students were often encouraged to focus heavily on getting into the most prestigious college possible. Today’s students may also be asking more practical questions:
How much will it cost?
How much financial aid will I receive?
How much debt might I have when I graduate?
What do graduates in my intended major earn?
And perhaps most importantly:
Will the investment pay off for me?
College Value Isn’t Just About Salary
Graduate earnings can provide useful information, but salary shouldn’t be treated as the sole measurement of the value of higher education.
Different careers have dramatically different compensation structures.
A graduate pursuing teaching, public service, social work, the arts or nonprofit work may earn less than someone entering engineering, finance or technology while still considering their education worthwhile.
There are also benefits of higher education that are difficult to capture in a salary statistic.
That’s why students comparing schools may want to look beyond an institution’s overall ranking and examine factors such as net price after financial aid, scholarships, graduation rates, student debt, internship opportunities, career placement, location and the strength of the program they actually intend to study.
The best-known university isn’t automatically the best financial or educational choice for every student.
Economic Diversity Also Gets Attention
The 2027 rankings also highlight economic diversity among highly ranked institutions.
According to U.S. News, MIT and Princeton rank third and fourth, respectively, among the top 25 National Universities in the percentage of students receiving federal Pell Grants.
Pell Grants generally assist undergraduate students with significant financial need and typically do not have to be repaid.
Among the top 25 National Liberal Arts Colleges, Amherst College ranked highest for economic diversity under the U.S. News measure.
A New Ranking Looks at In-State Value
U.S. News is also placing additional attention on affordability for students considering public universities.
The 2027 edition introduces a Best Value Schools for In-State Students ranking, which evaluates public universities based on academic quality and affordability for residents.
The University of North Carolina at Chapel Hill took the No. 1 position in the inaugural ranking.
That category could be particularly relevant to families deciding whether the prestige associated with attending a private or out-of-state university justifies potentially higher costs compared with attending a public institution in their home state.
The Rankings Look Different This Year
There is another important caveat when comparing the 2027 results with previous years.
Changes to the Carnegie Classification framework resulted in approximately 20% of previously ranked institutions moving into different U.S. News categories.
Because some colleges are now being compared against different groups of institutions, their 2027 rankings may not be directly comparable with previous years.
The changes also expanded eligibility, allowing additional institutions specializing in areas such as engineering, business and health to enter the rankings.
U.S. News also introduced an undergraduate economics specialty ranking while continuing rankings covering areas such as social mobility, innovation, historically Black colleges and universities, artificial intelligence programs, internships, undergraduate research and study-abroad opportunities.
Public Universities, HBCUs and Social Mobility
Among public National Universities, the University of California, Berkeley and UCLA tied for the No. 1 position, followed by the University of Michigan–Ann Arbor.
The top three Historically Black Colleges and Universities were:
- Spelman College
- Howard University
- Tuskegee University
For social mobility among National Universities, Florida International University and the University of California, Riverside tied for No. 1, with Oakland City University ranked third.
These categories illustrate another reason students may want to look deeper than a school’s overall national position. Different rankings can reveal institutions performing particularly well in areas that may matter more to an individual student.
So, Is College Worth It?
There isn’t one answer that applies to every student.
The cost of attending, financial aid, chosen major, career goals, likelihood of graduating and potential debt can dramatically change the financial equation.
A college with a famous name and high national ranking could be a poor financial choice for one student while a less prominent public university with generous financial aid could be an excellent investment for another.
That’s what makes the addition of Earnings by Major noteworthy.
Instead of asking only “Which college ranks highest?”, prospective students now have another reason to ask a much more personal question:
“What am I paying for — and what could I realistically get in return?”
MIT replacing Princeton at No. 1 makes the headline.
But for students and parents trying to decide whether college is worth the cost, the growing emphasis on outcomes, affordability and post-graduation earnings may ultimately be the more important story.
Source: U.S. News & World Report, 2027 Best Colleges rankings, released September 22, 2026.
U.S. News & World Report press release:
MIT Claims No. 1 Spot in U.S. News 2027 Best Colleges Rankings PR Newswire
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Health
Type 2 Diabetes Doesn’t Have to Be Your Future: Medicare Has a Benefit That Can Help
Left unchecked, prediabetes can progress to type 2 diabetes. However, with the right support, prediabetes can often be managed or even reversed. If you have Medicare, you may qualify for a Medicare-covered program that can help you lower your chances of developing type 2 diabetes – at no cost to you.
(Feature Impact) Nearly 1 in 2 people age 65 and older has prediabetes – a condition where blood sugar (glucose) levels run higher than normal. Left unchecked, prediabetes can progress to type 2 diabetes. However, with the right support, prediabetes can often be managed or even reversed. If you have Medicare, you may qualify for a Medicare-covered program that can help you lower your chances of developing type 2 diabetes – at no cost to you.
The Medicare Diabetes Prevention Program is a covered Medicare benefit that gives you practical tools, personalized support, and proven strategies to make healthy lifestyle changes. Learn how to eat better, exercise more, and build healthy habits that stick while guided by a certified coach who helps you every step of the way.
Research shows the program works. People with prediabetes who complete the program result in weight loss, which ultimately leads to reduced risk of type 2 diabetes onset.
What can you expect?
Prevention does not mean you have to make big changes all at once. This program helps you take small, realistic steps that can add up to lasting results. It includes 16 core sessions where you can learn how to reduce your diabetes risk by making healthier meals, moving more, and building healthy habits.
The core sessions are followed by six months of monthly maintenance sessions to help you keep your momentum.
You can choose the class format that works for you
You can enroll in these services from approved Medicare Diabetes Prevention Program suppliers and participate in the way most convenient for you:
- In-Person: Attend sessions in a community location.
- Live-Distance Learning: Join interactive group sessions from home.
- Self-Paced Online: This new option allows you to access online content and learn on your own schedule.
Visit www.medicare.gov/PreventDiabetes to find a class that’s right for you.
Who is eligible?
You may qualify if you are enrolled in Medicare Part B and meet these criteria:
- Have had one of the following test results within the past 12 months:
- Hemoglobin A1c between 5.7% and 6.4%
- Fasting plasma glucose between 110 and 125 mg/dL
- Two-hour plasma glucose between 140 and 199 mg/dL after an oral glucose tolerance test
- Have a body mass index (BMI) of 25 or higher (or 23 or higher if you self-report as Asian descent).
- Have never been diagnosed with type 1 or type 2 diabetes or end-stage renal disease (ESRD).
What does it cost?
If you have Medicare Part B and qualify for the program, you pay nothing to participate. If you are in a Medicare Advantage Plan, you may have to go to an in-network provider to get these services. Contact your plan for more information.
Ready to get started on your healthier future?
Take control of your health on your own terms, schedule, and pace that fits into your life. Check with your doctor to find out if you have prediabetes or are at risk for developing type 2 diabetes. If you’re eligible for the Medicare Diabetes Prevention Program, your doctor can refer you, or you can enroll on your own.
If you’re ready to get started today, find the class that’s right for you at: www.medicare.gov/PreventDiabetes.
Information provided by the U.S. Department of Health and Human Services
Photos courtesy of Shutterstock
SOURCE:
Centers for Medicare & Medicaid Services
