March 13, 2015
2 min read

Panel: Public health will benefit by raising legal age to purchase tobacco

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Raising the minimum age of legal access to tobacco products in the United States to 21 or 25 years may significantly decrease smoking prevalence and as a result, smoking-related mortalities, according to projections from the Institute of Medicine.

After the Family Smoking Prevention and Tobacco Control Act granted the FDA authority over tobacco products in 2009, the FDA requested that the Institute of Medicine (IOM) convene a panel to study the implications of raising the minimum age of legal access (MLA) to tobacco products. The committee, chaired by Richard J. Bonnie, LLB, of the University of Virginia, reviewed literature on tobacco use initiation, developmental biology and psychology and tobacco policy and used mathematical models to predict public health outcomes of raising the MLA to 19, 21 or 25 years.

Richard J. Bonnie, LLB

Richard J. Bonnie

Raising the MLA to 21 years would have a greater impact on delaying or preventing tobacco initiation vs. ages 19 or 25 years. Adolescents aged 15 to 17 years would be the most affected age group, according to Bonnie and colleagues.

Raising the MLA to 19 years would not have a significant effect on reducing social sources of tobacco among high school students, while raising the age to 21 years may achieve that.

“Raising the MLA to 21 will mean that those who can legally obtain tobacco are less likely to be in the same social networks as high school students,” the committee wrote.

Mathematical modeling predicted a 3% decrease in tobacco use if the MLA was raised to 19 years, a 12% decrease if raised to 21 years and a 16% decrease if raised to 25 years. As a result, tobacco-related disease would decrease. If the MLA was raised now, however, analysis suggests that these predictions would not be observed for at least 30 years.

In response to the IOM report, the AAP released a statement supporting the choice to raise the MLA for tobacco products.

Sandra G. Hassink, MD, FAAP

Sandra G. Hassink

“We know that one-third to one-half of young people who try a cigarette will go on to become daily smokers, and many of them will die prematurely from a smoking-related disease,” Sandra G. Hassink, MD, FAAP, president of the AAP, said in a press release. “This report lays the groundwork for critical policy discussions, and we urge our policymakers to carefully consider the health of our nation’s children in decisions over access to these dangerous products.”

Ultimately, the public health impact of raising the MLA rests with local and state governments and the degree to which policies are changed.

“These decisions will depend on each state’s or locality’s balance between personal interests and the privacy of young adults to make their own choice vs. society’s legitimate concerns about protecting public health,” Bonnie and colleagues concluded. “The committee is reasonably confident that raising the MLA will reduce tobacco use initiation, particularly among adolescents age 15 to 17 years of age; improve health of Americans across the lifespan; and save lives.”

For more information:

Access the full report at