STATE System Tobacco 21 Fact Sheet

Background

In the United States, tobacco use is the leading cause of preventable disease, disability, and death.1 More than 480,000 people die prematurely in the United States annually and another 16 million have a serious illness caused by smoking or exposure to secondhand smoke.1 Each year, smoking costs the United States nearly $170 billion in direct medical costs and more than $156 billion in lost productivity.

The percentage of US adults who were current cigarette smokers declined from 20.8% in 2005 to 15.3% in 2015; however, the Healthy People 2020 target is 12%.2,3 The age tobacco users initiate smoking is key to understanding and preventing tobacco use. Approximately 90% of adult cigarette smokers report that they first tried smoking before the age of 18 years, and almost all did so before the age of 26 years.1, 4, 6

All states and several territories have established a minimum legal age of sale (MLAS) to buy tobacco products in the United States. Raising the MLAS from 18 to 21 years has been suggested by the Institute of Medicine as an effective public health intervention to help achieve national health objectives to reduce tobacco use.4 The long-term effect of raising the MLAS to 21 years across the United States has the potential to lead to a decrease in cigarette smoking prevalence.4,5

States Activity to Reduce the Use of Tobacco Products by Prohibiting Youth Access and Mandating Minimum Legal Age of Sale (MLAS)

As of June 30, 2019, four states (California, Hawaii, New Jersey, and Oregon) and the District of Columbia have implemented a MLAS of 21 years to for cigarettes and electronic cigarettes (e-cigarettes). Beginning on July 1, 2019, Illinois and Virginia’s MLAS will increase to 21 and on July 16, 2019, Delaware’s MLAS will increase to 21. Beginning September 1, 2019, Vermont’s MLAS will increase to 21. Beginning on October 1, 2019, Connecticut and Maryland’s MLAS will increase to 21. Beginning on January 1, 2020, Washington’s MLAS will increase to 21. Three states currently have a MLAS of 19 years (Alabama, Alaska, and Utah). All other states have an existing MLAS of 18 years for the purchase of cigarettes and 48 states and the District of Columbia include e-cigarettes in their MLAS. Two states (Michigan and Pennsylvania) have no provisions establishing a MLAS for e-cigarettes.

Five states have passed laws increasing their MLAS to 21 with an established phase-in period. Arkansas, Maine, Massachusetts, Texas and Utah have either a two- or three-year period during which tobacco products can continue to be sold to those age 18 and older at the time of the law’s passage. The effect is that the MLAS will increase each year of the established phase-in period, until the MLAS of 21 takes effect and applies to all persons in the state under the age of 21 (excepting any exemptions in the law for sales to active military personnel) and thus is fully implemented. Beginning July 1, 2021, Arkansas’ and Massachusetts’ MLAS of 21 will apply to all persons under the age of 21; beginning December 31, 2021, Maine’s and Utah’s MLAS of 21 will apply to all persons under the age of 21; and beginning August 31, 2022, Texas’s MLAS of 21 will apply to all persons under the age of 21.

CDC tracks seven US Territories—American Samoa, Guam, the Marshall Islands, the Northern Mariana Islands, Puerto Rico, Palau and the US Virgin Islands, all of which have a MLAS of 18 years to purchase cigarettes, except Guam and Palau, which have an MLAS of 21 to purchase cigarettes. For e-cigarettes, the Northern Mariana Islands, Puerto Rico and the US Virgin Islands have a MLAS of 18 years; Guam and Palau have a MLAS of 21, and American Samoa and the Marshall Islands have no provision establishing a MLAS.

At the municipal level, there have been efforts to raise the MLAS to 21 years. States with local laws in effect establishing a MLAS of 21 years include Massachusetts (237 localities); Minnesota (34 localities); Ohio (32 localities); New York (25 localities); Kansas (22 localities); Missouri (21 localities), Connecticut (8 localities); Colorado (6 localities); New Hampshire (4 localities); Arkansas and Texas (3 localities); Arizona, Michigan, Rhode Island and Utah (2 localities each); and Alaska, Florida, Maine and Mississippi (one locality each).

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Access this full dataset on OSHData: CDC STATE System Tobacco Legislation – Youth Access.

1995-2019. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. Legislation—Youth Access. The STATE System houses current and historical state-level legislative data on tobacco use prevention and control policies. Data are reported on a quarterly basis. Data include information related to restrictions, enforcement and penalties associated with the sale of cigarettes and e-cigarettes to youth through retail sales and vending machines.

References

1. Centers for Disease Control and Prevention. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: US Dept of Health and Human Services; 2014.

2. Xu X, Bishop E, Kennedy SM, Simpson SA, Pechacek TF. Annual health care spending attributable to smoking: an update. Am J Prev Med. 2015;48(3):326–333.

3. US Department of Health and Human Services. Healthy People 2020 Website. Accessed April 11, 2017.

4. Institute of Medicine. Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Productspdf iconexternal iconpdf iconexternal icon. March 2015.

5. Winickoff JP, Hartman L, Chen ML,Gottlieb M, Nabi-Burza E, DiFranza JR. Retail impact of raising tobacco sales age to 21 years. Am J Public Health. 2014;104(11):e18–e21.

6. Tobacco21. Tobacco 21 Websiteexternal iconexternal icon. Accessed April 11, 2017.

DISCLAIMER: The STATE System contains data synthesized from state-level statutory laws. It does not contain state-level regulations; measures implemented by counties, cities, or other localities; opinions of Attorneys General; or relevant case law decisions for tobacco control topics other than preemption; all of which may vary significantly from the laws reported in the database, fact sheets, and publications.