We Already Know How To Reduce Teen Smoking and Vaping Without Raising Age To 21--So What Are We Waiting For?

A recent study in the medical journal Pediatrics only confirms what Twenty-One Debunked has been saying all along.   That is, tougher enforcement of the minimum sales age limit of 18, directed at vendors, does in fact lead to lower smoking as well as vaping rates among teens, and these lower usage rates apparently persist even after such youth reach the legal age to buy such products.

In this study, the proxy for tougher vendor enforcement was the grade (A through F) by the American Lung Association (ALA) on the strength of the local tobacco retail licensing (TRL) laws in the jurisdictions studied.  Strong TRL laws imply more frequent retail compliance checks with decoys, since such laws require licensing fees that make the program self-funding, and fines and penalties for violations such as failed compliance checks.  This in turn would lead to higher retailer compliance rates in adhering to the age limits for sales, and thus reduced access for youth below the age limit.  The study looked at various localities in California, in January-June 2014 and again in January 2015 through June 2016, while the age limit was still 18.

Unsurprisingly, jurisdictions with a grade of A (strong) for their TRL laws indeed had much lower teen smoking and vaping prevalence rates in the surveys compared to those with grades of D or F (weak).  At the same time, the ALA grades given for other local tobacco control laws (such as smoke-free laws) in place at the time did not seem to have much if any effect on youth smoking and vaping prevalence rates, and were statistically insignificant.

Thus, even though teens can still often manage to get cigarettes and such from their older friends and relatives (i.e. social sources), the net effect of restricted retail availability to people under 18 is significantly and persistently lower youth smoking and vaping rates.  Apparently generosity has its limits, and any forbidden fruit effect (reactance theory) of the age limit itself is outweighed in practice by greatly reduced access and convenience when retail compliance rates are very high, especially for younger and/or less mobile teens.  For example, if one in five retailers is willing to sell to people under 18, that is still pretty easy to get, but if only one in 20 retailers is willing to do so, that becomes very inconvenient to acquire and sustain a habit, especially in towns with only a few retail outlets.  Remember, a license to sell temptation goods like cigarettes and alcohol is practically a license to print money, and retailers would not want to jeopardize that by breaking the law when the law is strictly enforced with swift and certain sanctions for violations.

And while cigarette taxes were not studied here, since there would not have been within-state local variation in taxes, one should note that an older landmark study found that the two most important predictors of teen smoking rates over time (inversely) were 1) tax/price, and 2) retailer compliance rates.  This was particularly true for daily smoking rates.

Such results dovetail nicely with those of the famous studies of Woodridge, IL and Leominster, MA, in the 1990s that found that sustained tougher enforcement directed at vendors greatly reduces youth smoking rates without having to raise the age limit any higher than 18, and without having to involve the criminal justice system at all.  Now if only such logic would be applied to alcohol and cannabis as well.

And lest anyone claim that this would not apply to alcohol with a drinking age of 18, keep in mind that this is precisely what happened in the UK with both alcohol and tobacco upon implementing increased retail enforcement combined with higher tax rates on both substances.  So what are we waiting for?