Tobacco-21 laws can lower smoking prevalence in the 18-20 age group

A new study published today by the scientific journal Addiction found that raising the legal age of sale of cigarettes from 18 to 21 in the U.S. was associated with a 39% reduction in the odds of regular smoking in 18- to 20-year-olds who had experimented with cigarettes. The reduction was even greater (50%) in those who had close friends who smoked when they were 16.

The study compares smoking prevalence among 18-20 versus 21-22-year-olds, in regions that did versus did not raise the legal age of tobacco sales to 21. In areas with tobacco-21 laws, 18-20-year-olds were much less likely to smoke than their same-age peers in areas without these policies. That differential was not evident for 21-22-year-olds, who would not have been bound by the sales restriction but should have been affected by other local factors that might explain the younger age-group's differential smoking rate (e.g., other local tobacco policies, regional attitudes towards smoking).

Lead author Abigail Friedman, assistant professor at the Yale School of Public Health, commented, "This research indicates that a 'social multiplier' effect may amplify the impact of tobacco-21 laws. While these policies were associated with a 39% drop in the odds of regular smoking overall, the reduction was larger among young people whose friends were likely to smoke before tobacco-21 laws were adopted. As peer smoking is a critical predictor of youth smoking, this study suggests that tobacco-21 laws may help reduce smoking among those most susceptible to tobacco use. This result supports raising the age of sale to 21 as a means to reduce young adult smoking and improve public health."

As of June 2019, sixteen U.S. states and over 400 localities have adopted tobacco-21 laws.