Institute of Medicine Report… | Campaign for Tobacco-Free Kids
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Institute of Medicine Report Provides Powerful Evidence to Increase Tobacco Sale Age to 21 – States and Localities Should Act to Save Lives

Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids
March 12, 2015

WASHINGTON, DC – Today’s report by the Institute of Medicine (IOM) is a clarion call to states and localities across the country to raise the minimum age of sale for tobacco products to 21.

This report, by one of the most prestigious scientific authorities in the United States, strongly concludes that boosting the tobacco sale age to 21 will have a substantial positive impact on public health and save lives. It finds that raising the tobacco sale age will significantly reduce the number of adolescents and young adults who start smoking; reduce smoking-caused deaths; and immediately improve the health of adolescents, young adults and young mothers who would be deterred from smoking, as well as their children. Significantly, the greatest impact would be among adolescents 15-17 who would no longer be able to pass for legal age and would have a harder time obtaining cigarettes from their older friends and classmates.

Overall, the report predicts that raising the minimum age for the sale of tobacco products to 21 will, over time, reduce the smoking rate by about 12 percent and smoking-related deaths by 10 percent.

It is hard to imagine a clearer or more convincing message from this report. Within a short period of time, we expect to see states and localities act on this report to increase the age of sale for tobacco products to 21. It should provide a major boost in states such as Hawaii, California, Washington and New Jersey that are considering such legislation. The Hawaii House of Representatives last week approved statewide legislation to raise the tobacco sale age to 21, and the Senate should quickly do so (the sale age is already 21 in Hawaii County, the Big Island).

At least 58 localities in 7 states – including New York City – have already raised the tobacco sale age to 21. It’s time for others to follow suit and help make the next generation tobacco-free.

This report shows that increasing the tobacco sale age is a key new tool to prevent young people from ever becoming addicted to tobacco and starting on a path that all too often leads to serious disease and premature death. It should be adopted widely along with other proven measures to reduce tobacco use, including higher tobacco taxes, comprehensive smoke-free laws and well-funded tobacco prevention and cessation programs that include mass media campaigns.

Increasing the sale age to 21 will reduce tobacco use among youth and young adults – age groups when nearly all smoking begins and that are heavily targeted by the tobacco industry. National data shows that 95 percent of adult smokers begin smoking before they turn 21. The ages of 18 to 21 are a critical period when many smokers move from experimental smoking to regular, daily use. While half of adult smokers become daily smokers before 18, four out of five do so before they turn 21. Increasing the tobacco sale age to 21 will help prevent these young people from ever starting to smoke.

The tobacco industry never relents in pushing its deadly and addictive products, so policymakers can’t let up in their efforts to reduce smoking and save lives. A Philip Morris report from January 1986 made it clear decades ago that the industry knew a higher age of sale would hurt the peddling of its deadly products. “Raising the legal minimum age for cigarette purchaser to 21 could gut our key young adult market (17-20),” that report noted.

Today’s IOM report adds convincing weight to the argument that the higher age of sale will indeed keep tobacco away from the young people the industry constantly tries to attract.

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.

The Institute of Medicine is part of the U.S. National Academy of Sciences. The report and related materials can be found at