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Upping the minimum age for tobacco sales could spare thousands of lives and avert even more premature deaths, research suggests — though the outlook on teen vaping remains dubious.
President Trump on Friday approved a spending bill that would, among other provisions, increase the minimum legal age for tobacco purchases from 18 to 21. The bill also covers e-cigarette products, which have received great scrutiny amid a youth vaping epidemic and an outbreak of vaping-related lung illnesses linked to an additive in some THC products.
President Trump approved a spending bill that would, among other provisions, increase the minimum legal age for tobacco purchases from 18 to 21.
Among people born between 2000 and 2019, boosting the tobacco minimum age of legal access (MLA) to 21 nationwide would yield about 50,000 fewer lung-cancer deaths, 223,000 fewer premature deaths and 4.2 million fewer lost years of life, the report projected. These results likely won’t be observed for at least 30 years, the authors added, “assuming that the MLA increase occurs now.”
Research supports the potential public-health benefits of raising this age threshold, at least for traditional tobacco products. A 2015 Institute of Medicine report sponsored by the Food and Drug Administration estimated that raising tobacco products’ MLA to 21 would result in a 12% drop in tobacco-use prevalence by the time teenagers at that time were adults, though its models didn’t account for e-cigarette use.
Raising the minimum age to 21 “will begin to change access to tobacco products from social sources,” the report suggested, making folks who can legally buy tobacco less likely to be in high-school students’ social networks. Almost nine in 10 cigarette smokers had their first cigarette by age 18, according to the Centers for Disease Control and Prevention.
Nineteen states and Washington, D.C., have increased their minimum tobacco age to 21, says the Campaign for Tobacco-Free Kids, a nonprofit advocacy organization. Some 530 localities have done the same. Needham, Mass., which raised its tobacco legal age to 21 in 2005, saw a bigger drop in youth smoking between 2006 and 2010 than there was in surrounding communities without such a restriction, according to a 2015 study published in the journal Tobacco Control.
Nineteen states and Washington, D.C., have increased their minimum tobacco age to 21, says the Campaign for Tobacco-Free Kids.
The concept of a 21-year-old minimum age for tobacco access isn’t particularly novel, either, according to a 2016 National Cancer Institute-supported study published in the American Journal of Public Health.
“Restricting the sale and use of tobacco for individuals younger than 21 years was common throughout the late 19th and early 20th centuries in the United States,” the authors wrote. “During those years, higher MLAs were also viewed, with justification, as a means of improving enforcement of tobacco control laws.”
But some advocates argue that raising the tobacco age to 21, a measure backed by e-cigarette giant Juul and other tobacco companies, will do less to curb youth e-cigarette use than a ban on flavored products. President Trump had proposed a ban on most flavored e-cigarette products in September, but later backed away from the plan.
As the CDC puts it, “flavorings in tobacco products can make them more appealing to youth.” Two in three high-school students and nearly half of middle-school students in 2018 who had used tobacco products in the previous month said they’d used a flavored product.
President Trump had proposed a ban on most flavored e-cigarette products in September, but later backed away from the plan.
“Raising the tobacco age to 21 would be a positive step, but it is not a substitute for prohibiting the flavored products that are luring and addicting our kids,” Campaign for Tobacco-Free Kids president Matthew Myers said in a Dec. 11 statement.
The law “will not bring about meaningful change, but will lead to the tobacco companies falsely claiming that the youth e-cigarette problem has been solved even as it continues to grow worse every day,” he said.
Indeed, some health experts have suggested that tobacco companies backing the new law did so to avoid future scrutiny and regulation of their industry, NPR reported.
Juul, which controls about 75% of the American e-cigarette market, did not immediately return a MarketWatch request for comment on this criticism. The company last month stopped selling its popular mint-flavored products; it had earlier halted sales of its fruit-flavored e-cigarettes.
E-cigarette use among high schoolers increased by 78% between 2017 and 2018, according to the Centers for Disease Control and Prevention, and increased by 48% among middle schoolers. Recent e-cigarette use has driven the overall increases in youth tobacco use, the CDC says.
