Laws aimed at reducing young people’s access to cigarettes – so called “Tobacco 21” laws – should be extended more broadly across the nation, urge a trio of public policy experts, including Baylor College of Medicine’s Dr. Stephanie Morain. Their perspective article appears in the current issue of the New England Journal of Medicine.

Momentum for Tobacco 21 laws began to build in 2012 and today they have been enacted by at least 125 municipalities and other localities, including the state of Hawaii. The laws prohibit stores from selling tobacco and nicotine products – including e-cigarettes – to anyone under the age of 21. In most places, the age at which a person can buy cigarettes is 18.

Despite a proposed Tobacco 21 law being vetoed recently by the New Jersey governor, Morain, assistant professor in Baylor’s Center for Medical Ethics and Health Policy, and her colleagues believe that the laws are “ready to go to scale” across the country. Their article provides evidence that supports the broadening of the laws.

“Tobacco 21 laws offer a critical opportunity to protect the health of current and future generations,” said Morain, whose research focuses on the ethics and politics of public health laws. “Evidence from early adopters of these laws shows they are effective at reducing adolescent smoking rates. If implemented nationwide, these laws could prevent nearly a quarter of a million premature deaths from tobacco-related illness. Furthermore, public opinion data show strong majorities of Americans support these laws, and this support is strong across both political parties. While many things are controversial in the current political climate, this isn’t one of them – it’s time for America’s legislators to take action to protect adolescent health.” 

Morain and her colleagues gathered public opinion data from a July 2015 survey of a nationally representative sample of 1,125 U.S. adults regarding their attitudes toward various public health laws. They found that more than three-quarters of Americans support Tobacco 21 laws.  Support was high regardless of political party, with strong majorities of both Republicans and Democrats in favor of Tobacco 21 laws.

Expansion of the laws is supported by medical and health organizations, including the American Medical Association, the American Academy of Pediatrics and others, the article states. 

Her co-authors are Dr. Jonathan Winickoff, of Harvard Medical School and the American Academy of Pediatrics Julius B. Richmond Center of Excellence, and Dr. Michelle Mello, of Stanford University School of Medicine.