March 4, 2015 / 7:55 PM / in 4 years

Most Americans support raising tobacco sales age to 21

(Reuters Health) - More than two thirds of U.S. adults, including a majority of smokers, support raising the legal age to buy tobacco from 18 to 21, according to a 2013 survey.

Many municipalities nationwide, including 30 communities in Massachusetts alone, the Big Island of Hawaii and New York City, have passed laws banning sales to people under age 21 in recent years. As of January, 2015, that includes 49 cities in seven states covering 11.5 million people, according to an author of the new study.

“Our surveys have found that the American public strongly supports tobacco policies such as those that restrict where people can smoke and that raise tobacco taxes, so we were not so much surprised to find that most adults overall supported raising the age of sale to 21, but were interested to find both the majority of smokers and of adults ages 18-20 supported raising the age of sale,” Dr. Robert C. McMillen told Reuters Health by email.

McMillen, of the American Academy of Pediatrics and Mississippi State University in Starkville, and his coauthors used the 2013 results from the annual Social Climate Survey of Tobacco Control, which included responses from more than 3,000 randomly selected adults representative of the national population.

Respondents chose a level of agreement with the statement “The age to buy tobacco should be raised to 21.” They also answered questions about their own current and former smoking status.

Slightly more than 70 percent of adults supported or strongly supported raising the tobacco purchasing age, including 57 percent of current smokers. Most people, regardless of smoking status, age, geographic location, race, sex or education level supported the statement, according to the results in Tobacco Control.

“While implemented tobacco control measures often are widely supported in the population, it is more unusual for initiatives in-the-making to be associated with support this high,” said Gunnar Sæbø, a researcher at the Norwegian Institute for Alcohol and Drug Research in Oslo who was not part of the new study.

More than 68 percent of white respondents supported the statement, as did 72 percent of Hispanic respondents and 80 percent of black respondents.

Among smokers, those who had started between age 18 and 20 were most likely to support raising the tobacco age. Only 14 people in the survey were identified as current smokers under age 21, and only one supported raising the legal smoking age.

The legal age to purchase tobacco is regulated by states, not at the federal level.

“Some states, such as New York and Massachusetts, allow municipalities to raise the age of sale, whereas other states preempt that capacity and the action would have to be at the state level,” McMillen said.

As this is a new initiative, there hasn’t been much research on how it may affect the number of eventual smokers in the U.S., said Diana Silver, associate professor of public health at the NYU Steinhart school in New York.

“However, given the evidence that many underage smokers get their cigarettes from friends or others, efforts to restrict access to those 21 and older may make it much more difficult for 16 and 17 year olds to find a regular source of cigarettes,” she told Reuters Health by email.

“There hasn’t been a lot of research about the rigor and depth of enforcement of these laws, and there needs to be,” said Silver, who was not involved in the study. “Without it, we can’t know what contribution these laws can make.”

Needham, Massachusetts raised the age of sale to 21 in 2005, and the resulting drop in teen smokers has been encouraging, McMillen said.

“Surveys of Boston suburbs conducted between 2006 and 2010 found that cigarette smoking by Needham High School students had dropped by more than half while the surrounding suburbs fell only slightly,” he said.

SOURCE: bmj.co/18kdbDS Tobacco Control, online February 20, 2015.

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