Closing the youth access gap: The projected health benefits and cost savings of a national policy to raise the legal smoking age to 21 in the United States

Document Type

Article

Publication Date

12-2005

Publication Title

Health Policy

Volume

75

Issue

1

First page number:

74

Last page number:

84

Abstract

Current youth access laws, even if strictly enforced, do not prevent teenagers from obtaining cigarettes through social sources. To reduce the number of legal buyers a typical teenager routinely encounters, and to lessen ambiguity for vendors determining if a teen is of legal purchasing age, legislation raising the minimum legal purchase age (MLPA) for cigarettes to 21 has been discussed in several states. To estimate how a national law raising the smoking age to 21 would impact smoking prevalence, net costs (in terms of compliance enforcement, ID checking, and medical care) and health benefits (in terms of life years and QALYs) to the population over time, a dynamic computer simulation model was developed using publicly available secondary data. The model simulations were carried out for several scenarios assuming varying impacts of the policy change on smoking initiation probability over a 50-year period. One scenario assumes that smoking initiation probabilities for individuals under 21 shift by 3 years so a 18-year old in the simulation, for example, is as likely to initiate smoking as an 15-year old in the status quo. Under this assumption, raising the smoking age would reduce smoking prevalence for adults (age 18+) from the status quo level of 22.1–15.4% after 50 years. Prevalence would drop from 20 to 6.6% for 14–17-year olds, from 26.9 to 12.2% for 18–20-year olds, and from 21.8 to 15.5% for the 21+ group. The policy would produce a net cumulative savings to society of US$ 212 billion (driven by reduced medical costs), and the accumulation of nearly 13 million additional QALYs over the period.

Keywords

Adolescent smoking; Computer simulation; Enforcement; Policies; Prevention; Public health; Smoking – Prevention; Smoking – Law and legislation; Smoking uptake; System dynamics; Tobacco-sales laws; United States; 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

Publisher Citation

Sajjad Ahmad, Closing the youth access gap: The projected health benefits and cost savings of a national policy to raise the legal smoking age to 21 in the United States, Health Policy, Volume 75, Issue 1, December 2005, Pages 74-84, ISSN 0168-8510, 10.1016/j.healthpol.2005.02.004. (http://www.sciencedirect.com/science/article/pii/S0168851005000436)

UNLV article access

Search your library

Share

COinS