Minimum tobacco age laws

Evidence Rating  
Expert Opinion
Evidence rating: Expert Opinion

Strategies with this rating are recommended by credible, impartial experts but have limited research documenting effects; further research, often with stronger designs, is needed to confirm effects.

Health Factors  
Decision Makers

Minimum legal age for tobacco laws specify an age below which the purchase or public consumption of tobacco is illegal, often 18, 19, or 21. Some states have age restrictions for sales but have not passed laws setting a minimum consumption age. Initiatives to increase the age to 21 are often referred to as ‘Tobacco 21.’ Estimates indicate 95% of adult smokers began smoking before age 211.

Note: The term “tobacco” in this strategy refers to commercial tobacco, not ceremonial or traditional tobacco. County Health Rankings & Roadmaps recognizes the important role that ceremonial and traditional tobacco play for many Tribal Nations, and our tobacco-related work focuses on eliminating the harms and inequities associated with commercial tobacco.

Expected Beneficial Outcomes (Rated)

  • Reduced tobacco use

  • Reduced youth smoking

Other Potential Beneficial Outcomes

  • Improved health outcomes

Evidence of Effectiveness

Increasing the minimum legal tobacco age to 21 is a suggested strategy to reduce tobacco use among youth2. Available evidence suggests that increasing the minimum legal tobacco age to 21 is likely to reduce initiation of tobacco use, particularly among adolescents aged 15 to 173. Models indicate a 12% decrease in smoking prevalence over time as a result of such a change, as well as immediate improvements in the health of adolescents and young adults, and decreases in related long-term mortality3. Models estimate that increasing the legal smoking age from 18 to 21 could lead to $212 billion in savings over 50 years, driven largely by reduced medical costs4.

Surveys indicate growing public support for increasing the tobacco age, even among individuals who smoke5, 6.

Impact on Disparities

No impact on disparities likely

Implementation Examples

As of 2016, two states, California7 and Hawaii, have increased the minimum legal sale age for tobacco products to 218. At least 115 localities in nine states have a tobacco sales age of 21, including New York City, Cleveland, and Boston8.

Implementation Resources

Tobacco 21 - Preventing Tobacco Addiction Foundation. Tobacco 21.

PHLC-Tobacco sales restrictions - Tobacco Control Legal Consortium (TCLC). Sales restrictions. Saint Paul: Public Health Law Center (PHLC).

Footnotes

* Journal subscription may be required for access.

1 CTFK-Minimum tobacco age - Campaign For Tobacco-Free Kids. Increasing the minimum legal sale age for tobacco products to 21.

2 CDC-Youth and tobacco - Centers for Disease Control and Prevention (CDC). Youth and tobacco use.

3 IOM-Bonnie-2015 - Bonnie RJ, Stratton K, Kwan LY. Public health implications of raising the minimum age of legal access to tobacco products. Washington, DC: Institute of Medicine of the National Academies; 2015.

4 Ahmad 2005* - Ahmad S. Closing the youth access gap: The projected health benefits and cost savings of a national policy to raise the legal smoking age to 21 in the United States. Health Policy. 2005;75(1):74-84.

5 King 2015* - King BA, Jama AO, Marynak KL, Promoff GR. Attitudes toward raising the minimum age of sale for tobacco among U.S. Adults. American Journal of Preventive Medicine. 2015;49(4):583-588.

6 Farley 2015* - Farley SM, Coady MH, Mandel-Ricci J, et al. Public opinions on tax and retail-based tobacco control strategies. Tobacco Control. 2015;24(e1):e10-e13.

7 CDPH-Tobacco 21 - California Department of Public Health (CDPH). California Tobacco 21 Law. Resources for retailers.

8 CTFK-Communities - Hadley S. States and localities that have raised the minimum legal sale age for tobacco products to 21: Southampton. 2016;(5):2016.

Date Last Updated