By Tripp Mickle
A government-commissioned study supports increasing the tobacco
purchase age to 21 from 18, saying it would decrease early deaths,
cut low birth weights and "substantially" reduce the number of 15-
to 17-year-olds who begin smoking.
Only Congress, which required that the U.S. Food and Drug
Administration commission the report, has the power to increase the
tobacco purchase age nationally. States and cities can raise the
age in their jurisdictions.
The report by a panel at the independent Institute of Medicine
examined the impact of increasing the age to 19 on teenagers. The
committee also looked at how raising the age to 21 would affect 18-
to 20-year-olds, and how boosting it to 25 would affect 21- to
25-year-olds.
It concluded that increasing the age above 18 would most affect
15- to 17-year-olds, and found the impact of increasing the age to
21 "would be substantially higher than...19," but the impact of
raising it beyond 21 would be "considerably smaller."
The report adds momentum to a state and local grass-roots
movement to raise the legal age for buying cigarettes and other
tobacco products to 21, a trend that poses a serious challenge for
the $100 billion U.S. tobacco industry.
Raising the age would immediately deprive the industry of as
much as 2% of sales, according to an estimate published last year
in the American Journal of Public Health by Jonathan Winickoff,
associate professor of pediatrics at Harvard Medical School.
Tobacco companies differed in their reactions to the report.
Marlboro-maker Altria Group Inc. said Thursday that local
governments should let the FDA and Congress weigh in before
changing age limits. Camel-maker Reynolds American Inc. said it
would leave the minimum age up to city, state and federal
authorities. In a statement, Reynolds American said, "We are
opposed to youth use of tobacco and agree that the minimum age of
purchase is an important issue for discussion."
Several cities recently raised the minimum purchase age to 21,
including New York, Evanston, Ill., and Columbia, Mo., as did about
50 towns in Massachusetts. The majority of states have set the
minimum age for tobacco purchases at 18. Four states have it at 19.
The restrictions typically apply to all tobacco products, including
cigars, moist snuff and electronic cigarettes.
The Institute of Medicine report estimates that increasing the
tobacco purchase age to 21 would eventually reduce the number of
Americans who smoke by 12% and result in 249,000 fewer premature
deaths related to cigarette smoking for people born between 2000
and 2019. It also would result in about 286,000 fewer pre-term
births and 438,000 fewer babies born with low birth weights.
"We hope and expect there will be substantial consideration at
the state and local level of the findings of this report," said
Richard Bonnie, the chairman of the Institute of Medicine committee
and a University of Virginia School of Law professor.
An estimated 42 million Americans smoke. About 16% of
high-school students reported smoking a cigarette in the 30 days
prior to a 2013 survey by the Centers for Disease Control and
Prevention. The number of high-school smokers is a record low, down
from 19.5% in 2009 and 35% in 1999.
Increasing the legal age would help disrupt cigarette use before
it becomes ingrained as an adult habit. Nearly nine out of 10
smokers first light up by age 18, and 99% start by 26, according to
a 2012 report by the U.S. Surgeon General. About two-thirds of
smokers start lighting up daily before 18, and it appears to take
less nicotine for teenagers to become addicted, compared with
adults, the Surgeon General's report added.
"Right now, with 18 as the age, a 16-year old could easily come
into contact with an 18-year old, but they're much less likely to
come into contact with a 21-year old," said Robin Mermelstein, a
committee member and psychology professor at the University of
Illinois, Chicago.
More than 70% of Americans and 58% of current smokers support
raising the purchase age to 21, according to a study published last
month in the peer-reviewed journal Tobacco Control. It was the
first study to examine Americans' appetite for changing the status
quo. The majority said it was important that teens never experiment
with tobacco.
The Institute of Medicine report opened with a quote from
Goethe: "Knowing is not enough; we must apply. Willing is not
enough; we must do."
Write to Tripp Mickle at Tripp.Mickle@wsj.com
Corrections & Amplifications
An Institute of Medicine report estimates raising the tobacco
purchase age to 21 now would result in 249,000 fewer premature
deaths related to cigarette smoking for people born between 2000
and 2019. An earlier version of this article misstated the
figure.
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