The Institute of Medicine (IOM) on March 12 released a report providing a closer look at the likely public health outcomes associated with raising the minimum legal age (MLA) of legal access to tobacco products to 19 years, 21 years and 25 years.

The report, based on a review of existing literature on tobacco use initiation, development biology and psychology and tobacco policy, suggests that increasing the MLA for tobacco products “will likely prevent or delay initiation of tobacco use by adolescents and young adults.” According to the report, raising the MLA to 21 would likely have the greatest impact, compared to raising the age to 19 or 25. For example, raising the MLA to 21 would mean that those who can legally obtain tobacco are less likely to be in the same social networks as high school students. In addition, if the MLA were raised to 21 nationwide, the report authors estimate “there would be approximately 223,000 fewer premature deaths, 50,000 fewer deaths from lung cancer, and 4.2 million fewer years of life lost for those born between 2000 and 2019.”

The U.S. Food and Drug Administration cannot raise the MLA nationwide. However, states and localities can set a higher minimum age for their communities. Currently most states set the MLA at 18 years. However, four states have an MLA of 19 years, while several localities across the country have raised the MLA to 21 years.

“The IOM report provides further evidence to support raising the minimum age to purchase tobacco products,” said ACC President Patrick T. O’Gara, MD, FACC. “Not smoking is one of the most important things people can do to protect their cardiovascular health, and preventing young people from starting in the first place is important to the future health of our nation. The reduction in smoking is one of the biggest factors in the dramatic reduction of heart disease in the United States in recent decades. We want to continue this trend.”

According to the Campaign for Tobacco Free Kids, tobacco use is the number one cause of preventable death in the United States, killing more than 480,000 people and costing the nation about $170 billion in health care bills each year. If current trends continue, 5.6 million of today’s youth will die prematurely from a smoking-related illness. “Anything we can do to prevent these ills is indeed worthwhile and overdue,” said Matthew L. Myers, Campaign for Tobacco-Free Kids president, in a statement.

Keywords: Adolescent, Carcinoma, Bronchogenic, Heart Diseases, National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division, Mortality, Premature, Public Health, Smoking, Tobacco, Tobacco Use Disorder, United States Food and Drug Administration

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