Teen smoking dropped after minimum sales age rose

A new study co-authored by Stephen Buka, professor and chair of epidemiology at Brown University, reports that the Massachusetts town of Needham successfully reduced teen smoking when it raised the minimum sales age for cigarettes to 21.

In 2005, Needham became the first town in the country to raise the age from 18. In research led by the Education Development Center in Waltham, Mass., and published June 12 in the journal Tobacco Control, the authors compared teen smoking rates in the town and 16 others nearby between 2006 and 2010. They found that the prevalence of teen smoking in Needham dropped from 13 percent to 7 percent, a significantly greater drop than in the surrounding area where smoking fell from 15 percent to 12 percent.

Since 2012 some other communities have followed suit. If every town made the change and achieved the same result, Buka said, the health benefits would be huge.

"Teen smoking rates were cut in half after this law was introduced in Needham," he said. "Nationwide, that would result in 3 million fewer youth who would die early from a smoking related disease. These findings suggest one of the best possible strategies to reduce smoking related diseases, the leading cause of preventable death in the United States."

New research has shown significant declines in teen smoking after raising the minimum sales age for tobacco to 21. The study, led by EDC in collaboration with co-authors at Brown University and Harvard Medical School, examined trends in the actual prevalence of smoking associated with raising the minimum sales age. It was published online June 12 in the journal Tobacco Control.

The research focused on Needham, Massachusetts, which in April 2005 became the first town in the United States to raise the minimum tobacco sales age to 21; no other localities did so until 2012. The study found a significantly greater decline in smoking in Needham when compared to 16 communities west of Boston that maintained a minimum sales age of 18. The analysis examined data from the MetroWest Adolescent Health Survey, a biennial census survey of more than 16,000 high school students conducted by EDC and funded by the MetroWest Health Foundation since 2006.

The analysis found that from 2006 to 2010 teen smoking in Needham dropped almost in half—from 13 to 7 percent—a significantly greater decline than in the comparison communities where smoking decreased from 15 to 12 percent. This larger decline was consistent for both males and females, whites and nonwhites, and students in grades 10, 11, and 12. Cigarette purchases in stores among current smokers also declined significantly more in Needham than in the comparison communities.

Researchers say the findings support local action to raise the tobacco sales age to 21.

"Needham is an example for other communities considering policy changes to reduce youth smoking," said EDC's Shari Kessel Schneider, the study's lead author. "Our findings support efforts to raise the minimum sales age as a mechanism for preventing youth access to cigarettes, smoking initiation, and ultimately nicotine addiction."

The study also found that alcohol use trends in Needham were not comparable to those for tobacco, providing further evidence that the notable decline in smoking was likely related to the rise in the minimum sales age and not to a broader decline in substance use or reporting patterns.