Raising tobacco age would save lives, report says

Liz Szabo | USA TODAY

Raising the legal age to buy cigarettes to 21 would slash the smoking rate and save hundreds of thousands of lives by the end of the century, a new report shows.

Most states today allow people to legally buy cigarettes at age 18. Four states — Alabama, Alaska, New Jersey and Utah — allow tobacco to be sold only to those 19 and older.

Fifty-eight localities in seven states, including New York City, ban cigarette sales to people under 21, according to the Campaign for Tobacco-Free Kids.

The report stems from the 2009 law that gives the Food and Drug Administration authority to regulate tobacco. That law forbid the agency from setting a legal buying age for tobacco older than 18, but required the FDA to study the consequences of such a change.

The report, released Thursday, does not recommend any actions or policy changes.

But if every state were to immediately ban tobacco sales to those under 21, smoking prevalence would fall 12%, according to the report. That would prevent 249,000 premature deaths among the generation born between 2000 and 2019, including 45,000 fewer deaths from lung cancer, the report says. The change also would prevent 286,000 premature births; 483,000 cases of low birth weight; and 4,000 cases of sudden infant death syndrome.

Nearly 18% of adults smoke, or about 42 million Americans, according to the Centers for Disease Control and Prevention. More than 23% of high school students use tobacco in some form, including cigarettes, cigars, smokeless tobacco or hookahs.

Given that rate of smoking, about 5.6 million young people alive today will die prematurely from smoking, according to the Surgeon General.

About 95% of smokers pick up the habit before 21, studies show. Raising the age to buy tobacco to 21 would make it harder for teens to pass for legal age or get cigarettes from their older high school friends, says Matthew Myers, president of the Campaign for Tobacco-Free Kids.

"With 2,800 youth trying their first cigarette every day and many using multiple tobacco products, powerful interventions are needed to keep youth from lifelong addictions to these deadly products," says Chris Hansen, president of the American Cancer Society Cancer Action Network.

States shouldn't rush to raise the age for buying tobacco, says Brian May, a spokesman for tobacco giant Altria, formerly known as Philip Morris.

"Our perspective is that this is a complex issue and Congress has established a thoughtful process to better understand it," May says. "We believe states and localities should defer to this process and allow Congress the opportunity to think through this issue further before enacting different minimum-age laws."

Thomas Glynn, who reviewed the report for the Institute of Medicine, called the report a "monument to good science" and a "contribution to the health of every citizen in the U.S."

Glynn, a consulting professor at the Stanford Prevention Research Center at Stanford University's School of Medicine, says he was initially skeptical of the idea of raising the legal age to buy tobacco to 21.

"I know that critics of the report's conclusions will argue that, if we can send our 18-year- old men and women into combat to protect the U.S., we can hardly then turn around and say, 'But you can't buy cigarettes,' " Glynn says. "The public health response to that argument should be that our brave troops do not, thankfully, suffer the 50% casualty rate that cigarettes cause."