Raising the minimum sale age for tobacco to 21 has emerged as a highly recommended measure for tobacco control systems.

This blog reviews the history of Tobacco 21 measures and the research that has been conducted on the effectiveness of this measure at reducing tobacco or e-cigarette use by young people. (A downloadable version is available here.)

Tobacco 21 laws help protect young people from nicotine addiction

Almost all people who use tobacco products start doing so as teenagers or as young adults. (A recent study by Statistics Canada found “for both men and women, the age at which they started smoking remained virtually unchanged over the past 80 years”, with the “the peak age of initiation was 15 to 17 for women and 16 for men”.

obacco 21 laws help protect youth and young adults from experimenting with and becoming addicted to tobacco:

► They establish a new social and legal norm.
► They reduce the ability of younger teenagers to buy from their peer-group, creating a longer age buffer between those who are legally able to purchase and high-school students.
► They support policy change by post-secondary education institutions and employers.

Even those for whom Tobacco 21 laws will only defer the age of initiation can benefit:

► Those who start smoking at a younger age are more likely to find it difficult to quit.
► Nicotine use is harmful to the developing brains of young people.

Tobacco 21 laws are emerging as a new global standard

At least 8 countries have set the minimum sale age for tobacco products at 21.

The United States changed its Food, Drug and Cosmetic Act to raise the age from 18 to 21 on December 20, 2019. Prior to that date, half the U.S. population lived in the 19 states and 540 cities that had raised the minimum legal age for tobacco purchase to 21.

Other recent changes took place in the Philippines (early 2020) and Singapore (January 2021). The law was already in palce in Ethiopia (2019), Uganda (2016), Mongolia (2013), Honduras (2010), and Sri Lanka (2006). Countries which have set the age at 21 include Thailand (2017) and Japan (2001).

Prince Edward Island is the only Canadian jurisdiction to have adopted this measure. It came into effect on March 1, 2020.

Canadians and their health leaders support raising the legal minimum age to 21.

Surveys have consistently shown a high level of support for this higher age limit:

► In December 2019, an Ipsos Reid poll commissioned by Global News found that about 80% of Canadians supported raising the minimum age to 21 for the purchase of vaping products. The previous year support had been measured at 72%.

► A survey conducted by the ITC consortium found a 70% support for raising the age to 21 in Canada in 2018.

► In response to Health Canada’s consultation paper on “The Future of Tobacco Control in Canada”, about three-quarters (73%) of respondents supported the idea of raising the minimum legal age to 21.

Raising the minimum legal age for tobacco and vaping products to 21 is supported by all of the health charities (including the Canadian Cancer Society, the Heart and Stroke Foundation and the Lung Association) and also by nation’s chief medical officers of health.

Growing evidence on the benefits of Tobacco 21

Because Tobacco 21 laws were in place in several states and municipaliites well before national measures were adopted, U.S. researchers were able to compare the impact of this measure in jurisdictions which had adopted it and those which had not. Recently-published studies found:

► Tobacco 21 laws reduced smoking rates of 18 to 20 year olds by 2.5 to 4 percentage points. (The authors concluded it was more effective at reducing youth use than raising cigarette taxes).
Bryan, C, Hansen, B, McNichols, D, Sabia, JJ. Do State Tobacco 21 Laws Work? NBER Working Paper 28173

► States with Tobacco 21 laws did not have an increase in youth e-cigarette use between 2017 and 2019, although states with a lower legal age did.
Choi K, Omole T, Wills T, et al E-cigarette-inclusive smoke-free policies, excise taxes, tobacco 21 and changes in youth e-cigarette use: 2017–2019 Tobacco Control Published Online First: 25 February 2021.

► Overall tobacco sales decreased in states with Tobacco 21 laws, compared with those that did not.
Ali FRM, Rice K, Fang X,et al Tobacco 21 policies in California and Hawaii and sales of cigarette packs: adifference-in-differences analysis


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