Overview

Preventing youth smoking initiation is an important strategy to reducing tobacco-related diseases. E-cigarettes also called personal vaporizers or “vapes,” present another way for smokers to ingest nicotine. Sold in fruit and candy-flavors, the products encourage smoking initiation by teenagers. The vast majority of people who become addicted to nicotine start using tobacco and e-cigarette products before the age of 21. Many high school students turn 18 (the legal age of tobacco/ e-cigarette purchase in most states) during their senior year of high school and often purchase tobacco and e-cigarette products for younger students. As of August 2016, the US Food and Drug Administration (FDA) has extended its tobacco regulating authority to include e-cigarette products, restricting sales to minors younger than 18.

The 2015 Institute of Medicine (IOM) report Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products notes that raising the minimum legal age of purchase of tobacco products would reduce youth smoking initiation, particularly among children ages 15 to 17, leading to substantial reductions in tobacco use, improve the health of Americans across lifespan, and save millions of lives.

AAP Position

  • The minimum age to purchase tobacco and e-cigarette products should be increased to 21 years.
  • Laws and regulations prohibiting the sale of tobacco and e-cigarettes to minors should be vigorously enforced.
  • Legislation to increase the minimum age of purchase can be implemented at the state and local government levels.
  • Funding for enforcement activities can be provided from federal, state, or local revenues.
  • Point-of-sale advertising of tobacco and e-cigarette products should be prohibited.

Facts

  • Nearly 9 out of 10 cigarette smokers first tried smoking by age 18, and 99% first tried smoking by age 26.
  • Each day in the United States, more than 3,200 youth aged 18 years or younger smoke their first cigarette, and an additional 2,100 youth become daily cigarette smokers.
  • E-cigarette use increased 78% among high school students in 2018 from 11.7% in 2017 to 20.8% in 2018. In 2018, more than 3.6 million U.S. youth, including 1 in 5 high school students and 1 in 20 middle school students, currently use e-cigarettes.
  • Since 2014, e-cigarettes have been the most commonly used nicotine product among U.S. youth.
  • A 2015 Centers for Disease Control and Prevention (CDC) study showed that 75% of the American public, including 70% of current smokers, support Tobacco 21 laws.

Progress

  • 18 states and DC – laws banning sale of tobacco and e-cigarette products to youth younger than 21
  • 1 state law banning sale of e-cigarettes to youth younger than 21

For information on current law or pending legislation in your state, please contact AAP State Advocacy at stgov@aap.org.

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