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


Peer reviewed: Yes
Type of study: Survey
Subject of study: People
Funding: Government/research council

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.

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For editors:

Research reported in this press release was supported by grant number P50DA036151 from the National Institute on Drug Abuse, part of the National Institutes of Health (NIH), and FDA Center for Tobacco Products (CTP). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration.

This paper is free to download for one month after publication from the Wiley Online Library: https://onlinelibrary.wiley.com/doi/10.1111/add.14653 (after the embargo has lifted) or by contacting Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org, tel +44 (0)20 7848 0452.

To speak with lead author Dr. Abigail Friedman: contact her through the Yale School of Public Health by email (abigail.friedman@yale.edu) or telephone (+1 203 785 5760).

Full citation for article: Friedman AS, Buckell J, and Sindelar JL (2019) Tobacco-21 laws and young adult smoking: quasi-experimental evidence.  Addiction 111: doi:10.1111/add.14653.

Addiction is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, substances, tobacco, and gambling as well as editorials and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884. Addiction is the number one journal in the 2018 ISI Journal Citation Reports ranking in the substance abuse category (science edition).

31 July 2019 correction from lead author:  

The empirical analysis did not follow areas pre- and post- adoption of tobacco-21 policies. Thus, the following opening paragraph would be more accurate:

“A new study published today by the scientific journal Addiction suggests that raising the legal age of sale for cigarettes from 18 to 21 in the U.S. would reduce smoking among 18 to 20-year-olds. Specifically, living in a state or city with a minimum legal sales age of 21 was associated with a 39% reduction in the odds of regular smoking among 18- to 20-year-olds who had experimented with conventional or electronic cigarettes. The reduction was even greater (50%) among those who had close friends who smoked when they were 16.”