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Health Policy 75 (2005) 7484 Closing the youth access gap: The projected health

Summary: Health Policy 75 (2005) 7484
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
Sajjad Ahmad
Department of Civil, Architectural and Environmental Engineering, University of Miami,
Coral Gables, FL 33146-0630, USA
Received 25 August 2004; accepted 14 February 2005
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 22.115.4% after 50 years. Prevalence would drop from 20 to 6.6% for 1417-year olds, from 26.9 to 12.2% for 1820-year


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


Collections: Engineering