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[177] California retailers caught selling tobacco products to minors during these enforcement operations are subject to fines up to $6,000

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A 2015 report from the Institute of Medicine argued if the smoking age were raised to 21, there would be approximately 223,000 fewer premature deaths, 50,000 fewer deaths from lung cancer, and 4.2 million fewer years of life lost for those born between 2000 and 2019. In a related CNN opinion piece, US Senators Brian Schatz (D-HI) and Todd Young (R-IN), also argued that the age should be raised to 21 in part because smoking-related illnesses cost taxpayer money in the form of higher Medicare, Medicaid and other health care costs and that smoking-related illness in the United States costs more than $300 billion a year. Numerous organizations, including the American Cancer Society, American Heart Association, American Lung Association, and the American Academy of Pediatrics also support raising the smoking age to 21

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