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Health Policy 80 (2007) 378391 Limiting youth access to tobacco: Comparing the long-term

Summary: Health Policy 80 (2007) 378391
Limiting youth access to tobacco: Comparing the long-term
health impacts of increasing cigarette excise taxes and
raising the legal smoking age to 21 in the United States
Sajjad Ahmada,, John Billimekb,1
a Department of Civil, Architectural and Environmental Engineering, University of Miami,
1251 Memorial Drive, Coral Gables, FL 33146-0630, United States
b Department of Psychology and Social Behavior, University of California, Irvine,
3340 Social Ecology II, Irvine, CA 92697, United States
Although many states in the US have raised cigarette excise taxes in recent years, the size of these increases have been fairly
modest (resulting in a 15% increase in the per pack purchase price), and their impact on adult smoking prevalence is likely
insufficient to meet Healthy People 2010 objectives. This paper presents the results of a 75-year dynamic simulation model
comparing the long-term health benefits to society of various levels of tax increase to a viable alternative: limiting youth access
to cigarettes by raising the legal purchase age to 21. If youth smoking initiation is delayed as assumed in the model, increasing
the smoking age would have a minimal immediate effect on adult smoking prevalence and population health, but would affect a
large drop in youth smoking prevalence from 22% to under 9% for the 1517-year-old age group in 7 years (by 2010)--better
than the result of raising taxes to increase the purchase price of cigarettes by 100%. Reducing youth initiation by enforcing a
higher smoking age would reduce adult smoking prevalence in the long-term (75 years in the future) to 13.6% (comparable to
a 40% tax-induced price increase), and would produce a cumulative gain of 109 million QALYs (comparable to a 20% price


Source: Ahmad, Sajjad - Department of Civil and Environmental Engineering, University of Nevada at Las Vegas


Collections: Engineering