The Cost-Effectiveness of Raising the Legal Smoking Age in California

Document Type

Article

Publication Date

5-2005

Publication Title

Medical Decision Making

Volume

25

Issue

3

First page number:

330

Last page number:

340

Abstract

Given evidence that most smokers start smoking before the age of 18 and that smokers who start earlier in life are less likely to quit, policies that reduce or delay initiation could have a large impact on public health. Raising the legal minimum purchase age of cigarettes to 21 may be an effective way for states to reduce youth smoking by making it harder for teens to buy cigarettes from stores and by reducing the number of legal buyers they encounter in their normal social circles. To inform the ongoing debate over this policy option in California, this study provides an evaluation of the cost-effectiveness of raising the state’s legal smoking age to 21. Costs and benefits were estimated from a societal perspective using a dynamic computer simulation model that simulates changes to the California population in age, composition, and smoking behavior over time. Secondary data for model parameters were obtained from publicly available sources. Population health impacts were estimated in terms of smoking prevalence and the change in cumulative quality-adjusted life years (QALYs) to the California population over a 50-year period. Economic impacts were measured in monetary terms for medical cost savings, cost of law enforcement, and cost of checking identification. Compared to a status quo simulation, raising the smoking age to 21 would result in a drop in teen (ages 14-17) smoking prevalence from 13.3% to 2.4% (82% reduction). The policy would generate no net costs, in fact saving the state and its inhabitants a total of $24 billion over the next 50 years with a gain of 1.47 million QALYs compared to status quo. This research should prove useful to California’s policy makers as they contemplate legislation to raise the state’s legal smoking age.

Keywords

Adolescent smoking; California; Computer simulation; Cost-effectiveness; Enforcement; Prevention; Public health; Smoking – Prevention; Smoking – Law and legislation; Smoking uptake; System dynamics; Tobacco-sales laws; Youth – Tobacco use; Youth access laws

Disciplines

Civil and Environmental Engineering | Computational Engineering | Medicine and Health | Public Health

Language

English

Permissions

Use Find in Your Library, contact the author, or use interlibrary loan to garner a copy of the article. Publisher copyright policy allows author to archive post-print (author’s final manuscript). When post-print is available or publisher policy changes, the article will be deposited

UNLV article access

Search your library

Share

COinS