Raising the legal age to buy tobacco to higher than 18 would likely prevent premature death for hundreds of thousands of people, according to a report issued Thursday by the Institute of Medicine.
The report examines the public health impact of increasing the age to 19, 21 or 25. While it doesn't make any recommendations, officials say, it provides the scientific guidance states and localities need to evaluate policies aimed at reducing and eliminating tobacco use by young people.
It also intensifies renewed government efforts to reduce the death and disease caused by tobacco on the heels of the 50th anniversary of the landmark 1964 surgeon general's report that launched the anti-smoking movement.
Most states currently have set the age at 18, which is the federal minimum. Four states have set the age at 19 and several localities, including New York City, have raised the minimum age to 21. Increasing the federal age would take an act of Congress, which mandated the report in a 2009 law that gave the Food and Drug Administration authority to regulate tobacco.
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The report concluded that if it were to be raised to 21 now, it would result in about 249,000 fewer premature deaths, 45,000 fewer deaths from lung cancer and 4.2 million fewer years of life lost for people born between 2000 and 2019 when they reach their 40s and 50s.
Survey results released by the Centers for Disease Control and Prevention in June showed fewer than 16 percent of the teens smoked a cigarette in the previous month — the lowest level since the government started doing the survey in 1991, when the rate was more than 27 percent. Another CDC study had already put the teen smoking rate below 16 percent, but experts tend to treat this survey's result as the official number.
According to Thursday's report, 90 percent of the people who have ever smoked daily first tried a cigarette before 19 years of age and nearly all others tried their first cigarette before the age of 26.
If the minimum age were to be raised to 19 today, the report says, there'd be about a 3 percent decrease in smoking prevalence in 2100. That decrease would rise to 12 percent if it were to be raised to age 21 and 16 percent if it were raised to age 25.
There's a "growing interest" in raising the minimum age to buy tobacco and knowing what the public health implications would be before they act, said the report's committee chair, Richard J. Bonnie, a medicine and law professor and director of the Institute of Law, Psychiatry, and Public Policy at the University of Virginia in Charlottesville. "We have reasonable confidence that there will be substantial public health benefits by raise the age."