States that want to reduce rates of adult smoking should implement stringent tobacco restrictions on teenagers, a new study has said.
The researchers at Washington University School of Medicine in St. Louis discovered that states with more restrictive limits on teens purchasing tobacco also have lower adult smoking rates, especially among women.
The study said that compared with states with less restrictive limits, they also tend to have fewer adult heavy smokers.
"In most states for many years, it has been illegal to sell cigarettes to people under 18, but few provisions are in place to prevent those sales," the study's first author Richard A. Grucza, PhD, associate professor of psychiatry, said.
"This study shows that more restrictive policies can prevent teen smoking and be beneficial down the road," he added.
Grucza's team evaluated data from an ongoing National Cancer Institute survey that monitors smoking behavior in all 50 states.
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They also looked at the smoking restrictions in place in states when the study subjects were 17 years old.
"We looked at age 17 because in most states, it was illegal for anyone under 18 to buy tobacco products," Grucza said.
But how individual states chose to enforce the laws varied. Grucza's team focused on nine smoking-related policies and found that in states with enforcement policies, not only did 17-year-olds have more difficulty purchasing cigarettes, but that when they reached their 20s or 30s, they were less likely to smoke.
The four most effective restrictions included those on cigarette vending machines, in which the machines either were eliminated or housed in locations inaccessible to those under 18; identification requirements for purchasing cigarettes; restrictions on repackaging cigarettes so that five or 10 could be sold at a time, rather than an entire 20-cigarette pack; and prohibiting distribution of free cigarettes at public events.
Because cigarettes have been regulated by the U.S. Food and Drug Administration (FDA) since 2009, many of the more restrictive policies are in effect nationally, so Grucza's team believes future smoking rates among adults may decline at least partly as a result of those policies.
Interestingly, they found the policies to restrict youth access to tobacco had a big impact on women but didn't seem to influence smoking rates in men.
As more states around the country implement and enforce more restrictive policies, Grucza expects they may further reduce smoking rates.
Grucza said some states are considering restricting youth access even more.
In New York, there is a proposal to raise the age for tobacco purchases to 21. Meanwhile, in Alabama, Mississippi, Alaska and Utah, the minimum age for tobacco purchases already has been raised to 19.