Report reveals health benefits of raising smoking age

A public health professor from the Medical University of South Carolina was involved with a high-profile study that has people talking about whether the minimum age for buying cigarettes should be raised. 

Anthony J. Alberg, Ph.D., said he and his fellow Institute of Medicine committee members found it would save lives.

“Nationally, the current minimum legal purchase age is 18 years,” Alberg said. “The committee evaluated the implications of raising the age to 19 years, 21 years, and 25 years, and found that the older the age, the greater the impact on preventing the uptake of smoking and hence the greater the public health benefits.”

Alberg, who also serves as interim director of MUSC’s Hollings Cancer Center, studied the issue with the Committee on the Public Health Implications of Raising the Minimum Age for Purchasing Tobacco Products. The committee was part of the Institute of Medicine, the health arm of the National Academy of Sciences. It was asked by the Food and Drug Administration to conduct the study at the request of members of congress.

Most states require people to be 18 before they can buy tobacco products, although four (Alabama, Alaska, New Jersey and Utah) have raised the minimum age to 19. Some cities have gone beyond that. In Manhattan, for example, the tobacco-purchasing age is 21.

Committee Chair Richard J. Bonnie is the Harrison Foundation professor of Medicine and Law and director of the Institute of Law, Psychiatry and Public Policy at the University of Virginia. He said while some cognitive abilities are well developed by age 16, the parts of the brain most responsible for decision-making and impulse control continue to develop until about age 25.

“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,” Bonnie said. “These concerns support an underage access restriction, but they do not resolve the policy question about the specific age at which the line should be drawn.”

Of the people who have ever smoked daily, 90 percent first tried a cigarette before 19 years of age, and nearly all others tried their first cigarette before the age of 26.
Researchers say that suggests if someone is not a regular tobacco user by the age of 25, that person will probably not become one in the future.

Alberg said the public health benefits of raising the smoking age would be immediate and would increase over time. “For example, for those born between 2000 and 2019, raising the minimum legal purchase age to 21 years today would prevent almost 250,000 smoking-caused deaths.”

Cigarette smoking causes a range of health problems including lung issues, heart disease and cancer. The report found that raising the tobacco purchasing age would not only reduce those problems but also improve the health of babies by reducing the likelihood that their parents smoke. It suggests there would be fewer pre-term births, cases of low birth weight and an estimated 4,000 fewer sudden infant death cases.

The report adds to decades of tobacco research and control efforts, including extensive work at MUSC. Alberg has a broad background in studying cigarette smoking, including the effects of secondhand smoke and prevention programs. He holds the Blatt Ness Distinguished Endowed Chair in Oncology at MUSC. He’s also associate director of Population Sciences at the Hollings Cancer Center.

Alberg said he was proud to serve on the committee that issued the report on the health benefits of raising the age for tobacco purchases.

“It was an honor to participate in the important work of this committee, particularly knowing the severe toll that cigarette smoking takes on the health of South Carolinians,” Alberg said.

“I hope this report will stimulate discussions and action to raise the minimum legal age for purchase of tobacco products nationally and here in South Carolina.  The health of our younger generation makes the stakes too high to ignore this valuable policy option.”