If people could not get cigarettes until the age of 21, lives would be saved because fewer people would start smoking, said a report by the Institute of Medicine on Thursday.
Most smokers begin their habit when they are young. Some 90 percent of smokers say they first tried a cigarette by the time they turned 19, and nearly all the rest experimented by the age of 26.
A committee of experts tasked by the US Food and Drug Administration with studying scientific literature on smoking looked at how changing the age of being able to access cigarettes — whether 19, 21 or 25 — would impact smoking rates.
If the legal age were raised to 19, smoking prevalence would drop by three percent by the year 2100, it found.
Were the legal age set at 21, there would be a 12 percent decrease in smoking prevalence by the end of the century.
And if the minimum legal age were set at 25, there would be a 16 percent decrease in smoking prevalence by the year 2100.
No recommendation was made by the report, which will be delivered to government agencies.
The Family Smoking Prevention and Tobacco Control Act of 2009 granted the FDA broad authorities over tobacco products, but barred it from establishing a nationwide minimum legal age for tobacco products that would be higher than 18 years of age.
Despite decades of public health efforts to reduce smoking, 40 million Americans — or about one in five adults — continue to smoke.
Cigarettes are sold in most states to customers age 18 and over. Four states (Alabama, Alaska, New Jersey, and Utah) have set the minimum age to 19, and New York City and several other localities nationwide have raised it to 21.
“While the development of some cognitive abilities is achieved by age 16, the parts of the brain most responsible for decision making, impulse control, and peer susceptibility and conformity continue to develop until about age 25,” said committee chair Richard Bonnie, director of the Institute of Law, Psychiatry, and Public Policy at the University of Virginia in Charlottesville.
“A balance needs to be struck between the personal interests of young adults in being allowed to make their own choices and society’s legitimate concerns about protecting the public health and discouraging young people from making decisions they may later regret, due to their vulnerability to nicotine addiction and immaturity of judgment.”
Cigarette smoking causes cancer and has been linked to diabetes, heart disease and premature death.
The committee also found that if the minimum age were raised to 21 nationwide, there would be approximately 249,000 fewer premature deaths among today’s youth, including 45,000 fewer deaths from lung cancer.
“By assessing the public health implications of raising the minimum age for accessing tobacco products, this report aims to provide the scientific guidance that states and localities need when evaluating new policies to achieve the ultimate goal — the reduction and eventual elimination of tobacco use by children and youth,” said Victor Dzau, president of the Institute of Medicine.