New research from the University of Nottingham suggests England could see smoking prevalence among young adults fall below 5% significantly earlier than anticipated if the government implements a phased increase in the legal age for tobacco sales.
The study, led by researchers at the University of Nottingham, indicates that a progressive rise in the minimum legal sales age (MLSA) for tobacco could accelerate the decline in smoking rates among individuals aged 12 to 30. This finding aligns with growing international interest in raising the MLSA, currently set at 18 in most jurisdictions, to 20 or even higher.
A systematic review of studies, published in Nicotine & Tobacco Research, examined the impact of “Tobacco 21” laws – those raising the MLSA to 21 – specifically in the United States. The review, encompassing 23 studies and 34 estimates of association, found moderate-quality evidence that such laws reduce overall cigarette sales and current smoking rates among 18- to 20-year-olds. Lower-quality evidence suggested a reduction in smoking among younger adolescents, aged 11 to 17. The positive effects were more pronounced among individuals with lower levels of education.
The research team, part of the multi-university SPECTRUM collaboration focusing on the commercial determinants of health and health inequalities, assessed data from January 2015 to April 2024. The review utilized a preregistered protocol on PROSPERO (ref: CRD42022347604) to ensure methodological rigor. Researchers used the ROBINS-I tool to assess risk of bias and GRADE to assess the quality of evidence.
While the reviewed studies primarily focused on the United States’ “Tobacco 21” legislation, the findings offer insights applicable to the English context, particularly given the UK government’s recent consideration of similar measures. The University of Nottingham’s perform contributes to a broader understanding of the commercial determinants of health, aiming to reduce harm arising from tobacco, alcohol, and other commercial products.
A 2022 survey evaluating attitudes and exposure to illicit tobacco in England, conducted by researchers, examined adult perspectives on the issue, though it did not directly address the impact of raising the MLSA. The findings of the Nottingham study are expected to inform ongoing policy debates regarding tobacco control strategies in England.
