Tobacco 21 is a campaign to prevent youth tobacco use in the United States, primarily through laws that raise the minimum legal age to purchase tobacco and nicotine in the United States to 21. It also refers to various federal, state, and local laws based on Tobacco 21's model policy, raising the minimum sales age to 21. Many tobacconists (also called smoke shops or tobacco shops) also prohibit minors below this age from entering the facility.
History
Tobacco 21 is produced and funded by the Preventing Tobacco Addiction Foundation, a public health nonprofit organization established in 1996. Several national non-profit organizations, including the American Cancer Society in Oregon, had supported raising the tobacco age. The Tobacco 21 movement emerged in February 2003 when Needham, Massachusetts became the first municipality to enact a law raising the minimum legal sales age to 21. On December 20, 2019, President Donald Trump signed the 2020 United States federal budget which raised the federal smoking age to 21.
Rationale Studies show that around 95% of adult smokers tried cigarettes before turning 21, while 80% of them had their first cigarette before their 18th birthday. Adult smokers may supply tobacco products to younger consumers. The National Academies concluded that underage users primarily obtain tobacco from social sources such as friends and relatives, rather than from the illegal commercial market. Tobacco 21 law supporters believe that teenagers have fewer acquaintances aged 21 who could purchase nicotine delivery products for them. The chosen age limit also has a precedent in the alcohol industry. The U.S.-wide legal age of 21 for the purchase of alcohol products is credited for reduced consumption among young people, as well as decreased alcohol addiction and drunk driving cases, but this claim is widely disputed and further research suggests raising the age had no effect on underage access and drunk driving rates.
Scientific aspect The major scientific publication in support of Tobacco 21 is the Institute of Medicine's report "Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products", which concluded by saying: "if the MLA were raised now to 21 nationwide, 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." An editorial in the New England Journal of Medicine called Tobacco 21 "An idea whose time has come". There is mixed scientific evidence on the impact a tobacco-purchase age limit of 21. Older studies, including a review in 2011, provided evidence against the idea that raising the drinking age to 21 has actually saved lives in the long run. In one study, Miron and Tetelbaum (2009) discovered that when the federally coerced and non-coerced states were separated out, any lifesaving effect is no longer statistically or practically significant in the coerced states, and even in the voluntary-adopting states the effect does not seem to last beyond perhaps the first year or two. And while a 2023 study that controlled for state-level differences found that the passage of Tobacco 21 laws is associated with a 2-to-4 percentage-point decline in smoking participation among 18-to-20-year-olds and a spillover effect of a reduction in smoking among youth aged 16–17, a 2024 study found a much weaker effect size (less than one percentage point decline in smoking, vaping, and smokeless tobacco use) for the federal Tobacco 21 law, and no significant effect for state-level Tobacco 21 laws among young adults.
Endorsements The following organizations have endorsed Tobacco 21 at the national level, either through their own statements or through endorsement of Senate Bill 2100, the federal bill to raise the tobacco age to 21:
Campaign for Tobacco Free Kids American Heart Association American Lung Association American Medical Association Institute of Medicine American Academy of Family Physicians American Academy of Pediatrics Society for Adolescent Health and Medicine Counter Tobacco Action on Smoking and Health Tobacco Control Legal Consortium Clearway Minnesota / Minnesotans For A Smoke Free Generation Oral Health America American Cancer Society Cancer Action Network Academic Pediatric Association American Pediatric Society American Veterans (AMVETS) American Public Health Association American Congress of Obstetricians and Gynecologists Trust for America's Health Association of Medical School Pediatric Department Chairs First Focus Campaign for Children Pediatric Policy Council Society for Pediatric Research Association of Asian Pacific Community Health Organizations Asian Pacific Partners for Empowerment, Advocacy, and Leadership (APPEAL) Hawai‘i Medical Service Association Coalition for a Tobacco-Free Hawai‘i
United States
State and national movement
Hawaii Hawaii's Tobacco 21 bill was signed by Governor David Ige and raised the legal age to purchase tobacco products, including electronic smoking devices, to 21, beginning on January 1, 2016. The legislation of this bill arose after the Institute of Medicine released a report explaining that raising the age to 21 would have significant public health benefits. The report estimated that making the minimum age 21 would result in avoiding nearly 250,000 premature deaths and 50,000 fewer deaths from lung cancer among individuals born between 2000 and 2019. Under the bill, anyone caught breaking the law faces a $10 fine for the first offense and a $50 fine or community service for a second offense. Retailers caught selling to individuals under the age of 21 pay penalties ranging from $500 to $2,000. A press release on the governor's website explained the decision by referencing that in the United States, 95 percent of adults smokers begin smoking before the age of 21. Almost half of those become regular smokers before the age of 18 and another 25% become regular smokers between the ages of 18 and 21.
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