Report: Raising tobacco sales age would curb addiction

Raising the minimum legal age for purchasing tobacco products from 18 to 21 would accelerate the reduction in tobacco use by youth, according to a report by the Institute of Medicine released on March 12.
 
Raising the minimum age would result in immediate improvement of adolescent health, a long-term reduction in smoking-related diseases and mortality, and reduced public exposure to secondhand smoke, according to the report.
 
A minimum age of 21, for example, would decrease smoking initiation rates by 15 percent for youths under age 15; 25 percent for youths of 15 to 17; and 15 percent for youths in the range of 18 to 20.
 
In Massachusetts, the “minimum legal sales age” for tobacco products is 18 except in 50 cities and towns that have enacted policies raising the age to 21 and four municipalities that have set the minimum age at 19. (In 2005, Needham was the first in the nation to raise the minimum legal age to 21.)
 
Nationwide, the minimum legal age, or MLA, for purchasing tobacco products is 18 in all but four states – Alabama, Alaska, New Jersey and Utah – where it is 19.
 
The U.S. Food and Drug Administration commissioned the Institute of Medicine to conduct its study on direction from Congress. The 2009 Family Smoking Prevention and Tobacco Control Act required the FDA to convene a panel of experts to assess the health implications of raising the minimum legal age for purchasing tobacco products.
 
The Institute of Medicine chose to focus on the health implications of raising the MLA from age 18 to age 19, 21 and 25. The IOM was commissioned to assess the likely public health outcomes of raising the MLA, but not to make recommendations.
 
According to the study, 90 percent of smokers start at age 18 or younger, before their brains are fully developed for decision-making or impulse control and when they “are uniquely vulnerable to the effects of nicotine.”
 
While an increase of the MLA to 19 would be helpful – especially as there are few 19-year-old high school students who could be the “social source” for tobacco for their under-aged peers – the additional year would have a limited effect on decreasing the initiation rate, according to the study.
 
Raising the MLA to 21 would make it much more difficult for youths to obtain tobacco, particularly the age group of 15- to 17-year-olds. Other studies have found that the younger a smoker becomes addicted to tobacco, the more difficult it is for him or her to end the nicotine addiction.
 
An MLA of 25, meanwhile, did not provide much additional benefit compared with an MLA of 21, the study found.
 
The IOM noted that its data relies on the current level of national tobacco control efforts, a review of existing literature on youth tobacco use and adolescent nicotine addiction, and mathematical modeling for predictions.
 
The study does not address electronic cigarettes. All Massachusetts cities and towns with a minimum legal purchase age of 21 include e-cigarettes in their tobacco sales policy.
 
In practical terms, a minimum age of 21 for tobacco product purchases matches the minimum age for purchasing alcohol in Massachusetts and would be much more politically feasible than an increase to age 25.
 
The report does not present an increase of the MLA as a “silver bullet” for preventing youths from smoking. It would likely be one component of an arsenal of tobacco sales policies that Massachusetts cities and towns currently rely on to successfully reduce youth initiation and use.
 
Newer local policies include capping the number of local tobacco sales permits, minimum pricing for cigars, and a ban on flavored products, exempting menthol, that extends the federal 2009 flavored cigarette ban to all tobacco products and e-cigarettes, with limited exceptions.
 
Massachusetts currently has a youth smoking rate of 11 percent.