In most countries the minimum age to buy tobacco products is 18. Raising the national minimum age to buy cigarettes to 21 would save lives by preventing adolescents from ever taking up smoking, a new report suggests.
In their analysis, Ohio State University public health experts detail how raising the minimum tobacco sales age would be effective in improving health and note the economic consequences to retailers would be minimal.
‘The Ohio State report says that if current trends continue, 5.6 million young people alive today will die prematurely from tobacco use.’
If the age were raised nationally, those U.S. residents born between 2000 and 2019 would experience 223,000 fewer premature deaths, 50,000 fewer lung cancer deaths and 4.2 million fewer years of life lost, according to a 2015 Institute of Medicine report cited in the Ohio State white paper.
The IOM report also estimated that raising the smoking age would, by 2100, result in 285,000 fewer pre-term births, 438,000 fewer low-birth-weight babies and 4,300 fewer sudden, unexplained deaths in infancy.
While cigarette smoking has declined among U.S. youth, overall use of tobacco (including e-cigarettes and cigars) has increased or remained stable. Nearly all adult smokers began by the age of 18 - almost no one starts after 21, the experts point out in their argument for changing the law nationally.
"The key point is that if people get through adolescence without smoking, it is highly unlikely they will ever start," said Micah Berman, assistant professor of public health and law at Ohio State. "The flip side of that is if they do start smoking in adolescence, everything we have learned about teen brain development shows that it will be much harder for them to quit later."
Berman co-authored the paper, published by Ohio State's College of Public Health, with Rob Crane, clinical associate professor of family medicine; Natalie Hemmerich, an attorney and postdoctoral fellow in public health; and Thomas Geist, regional director of the Preventing Tobacco Addiction Foundation.
At least 176 municipalities in 11 states have adopted a policy of restricting tobacco sales to those over 21, as have the entire states of California and Hawaii.
The Ohio State researchers cite dozens of studies to support their conclusions. For example, previous research has suggested:
- Nicotine's effect on brain development leads adolescents to heavier daily tobacco use, a stronger nicotine addiction and more trouble with quitting later in life.
- Raising the minimum sales age to 21 puts legal purchasers outside the social circle of most high-school students. Most people supplying cigarettes to teens are 18 to 20, and many of them are still in high school.
- Raising the legal drinking age to 21 reduced alcohol use, daily drinking and binge drinking by more than a third among high-school seniors.
- Raising the legal smoking age can reduce racial and ethnic disparities because nonwhite young adults are more likely than whites to start smoking after turning 18.
In 2005, Needham, Massachusetts, became the first U.S. city to increase its tobacco sales age to 21 - a case study that offers useful data as other cities consider the same change. After the law passed, tobacco use among high-school students dropped almost in half - and also decreased significantly faster in Needham than in the 16 surrounding communities that sold cigarettes to 18-year-olds.