Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2019 Oct;114(10):1816-1823.
doi: 10.1111/add.14653. Epub 2019 Jul 24.

Tobacco-21 laws and young adult smoking: quasi-experimental evidence

Abigail S Friedman  1 , John Buckell  1 , Jody L Sindelar  1
Affiliations
Observational Study

Tobacco-21 laws and young adult smoking: quasi-experimental evidence

Abigail S Friedman et al. Addiction. 2019 Oct.

Abstract

Aims: To estimate the impact of tobacco-21 laws on smoking among young adults who are likely to smoke, and consider potential social multiplier effects. Design Quasi-experimental, observational study using new 2016-17 survey data.

Setting: United States.

Participants/cases: A total of 1869 18-22-year-olds who have tried a combustible or electronic cigarette.

Intervention and comparators: Tobacco-21 laws raise the minimum legal sales age of cigarettes to 21 years. Logistic regressions compared the association between tobacco-21 laws and smoking among 18-20-year-olds with that for 21-22-year-olds. The older age group served as a comparison group that was not bound by these restrictions, but could have been affected by correlated factors. Age 16 peer and parental tobacco use were considered as potential moderators.

Measurements: Self-reported recent smoking (past 30-day smoking) and current established smoking (recent smoking and life-time consumption of at least 100 cigarettes).

Findings: Exposure to tobacco-21 laws yielded a 39% reduction in the odds of both recent smoking [odds ratio (OR) = 0.61; 95% confidence interval (CI) = 0.42, 0.89] and current established smoking (OR = 0.61; 95% CI = 0.39, 0.97) among 18-20-year-olds who had ever tried cigarettes. This association exceeded the policy's relationship with smoking among 21-22-year-olds. For current established smoking, the tobacco-21 reduction was amplified among those whose closest friends at age 16 used cigarettes (OR = 0.50; 95% CI = 0.29, 0.87), consistent with peer effects moderating the policy's impact on young adult smoking.

Conclusions: Tobacco-21 laws appear to reduce smoking among 18-20-year-olds who have ever tried cigarettes.

Keywords: Cigarettes; policy; smoking; tobacco control; tobacco-21; young adults.

PubMed Disclaimer

Conflict of interest statement

Declaration of Interests: None of the authors have any conflicts of interest with this research. Research was supported by grant #P50DA036151 from the National Institute on Drug Abuse and the Food and Drug Administration (FDA) Center for Tobacco Products to Yale University. Neither the National Institutes of Health (NIH) nor the FDA had any role in the study’s design or conduct; the data’s collection, analysis, or interpretation; or the manuscript’s preparation. Content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or FDA.

Figures

Figure 1:
Figure 1:
Mechanism for Tobacco-21 Effect on Young Adult Smoking Notes: Solid arrows denote the policy’s direct effects on young adult behavior, while striped arrows denote indirect effects. If the individual and their peers respond to both the policy and each other’s behavior, these indirect effects will reinforce each other, such that the policy has an even greater impact on own and peer smoking. We refer to this as a social multiplier effect.
See this image and copyright information in PMC

References

    1. Institute of Medicine. Public health implications of raising the minimum age of legal access to tobacco products [Internet]. 2015. URL:https://www.nap.edu/download/18997. Accessed: 2018-12-11. (Archived by WebCite® at http://www.webcitation.org/74aapMt4w) - PubMed
    1. Schneider KS, Buka SL, Dash K, Winickoff JP, Donnell L. Community reductions in youth smoking after raising the minimum tobacco sales age to 21. Tob Control. 2016;25(3):355. - PubMed
    1. Macinko J, Silver D. Impact of New York City’s 2014 Increased Minimum Legal Purchase Age on Youth Tobacco Use. Am J Public Health. 2018;108(5):669–75. - PMC - PubMed
    1. Jason LA, Ji PY, Anes MD, Birkhead SH. Active enforcement of cigarette control laws in the prevention of cigarette sales to minors. JAMA. 1991;266(22):3159–61. - PubMed
    1. Ross H, Chaloupka FJ. The Effect of Public Policies and Prices on Youth Smoking. South Econ J. 2004;70(4):796–815.

Publication types