Smoking age: here's what effect raising it to 21 could have in England

Smoking is one of the leading causes of preventable death in the UK – accounting for nearly 100,000 deaths each year. In England alone, smoking caused nearly 75,000 deaths in 2020. In economic terms, smoking costs the economy an estimated £19 billion a year – with smoking-related health issues alone costing the NHS around £6 billion per year. Given the significant burden caused by smoking, it's no wonder the government wants to make England smoke-free by 2030. Wales and Scotland have also introduced similar policies.

A recently published independent review has now outlined 15 important interventions needed to help achieve this goal. Some of these recommendations include promoting vaping as an alternative to cigarettes and increasing duties on tobacco products. The report also recommends raising the age a person can buy cigarettes from 18 to 21 – then increasing the age of sale by one every year thereafter.

England wouldn't be the first country to increase the age a person can legally buy tobacco products in a bid to tackle smoking. In 2019, the US introduced legislation that changed the minimum age a person could purchase tobacco products from 18 to 21. In 2021, New Zealand also became the first country in the world to implement a "tobacco-free generation" policy, banning all sales of tobacco to anyone born after 2008.

While it's still too early to know what impact New Zealand's new smoking ban has had on rates, when they previously raised the legal age to buy tobacco, smoking rates declined across all age groups from 18.2% of the population in 2012 to 13.4% in 2020. In the US, the number of smokers also declined after the minimum purchasing age was raised.

This also wouldn't be the first time the UK increased the legal age for buying cigarettes. When the age of sale was increased from 16 to 18 in 2007, there was a fall in youth smoking rates. Given the knock-on effect that raising the smoking age can have on overall smoking rates, it makes sense for the UK to use this strategy again.

In 2019, around 15% of 18 to 20-year-olds reported smoking. In England, that amounts to around 364,000 people. Though this may only be a fraction of the population, research shows that the earlier a person begins smoking, the more likely they are to become dependent and develop smoking-related health problems. Raising the legal age would both help reduce the likelihood of someone becoming addicted to nicotine and developing health problems later in life. Research also suggests that raising the legal smoking age can prevent young adult smokers transitioning into long-term smokers.

Evidence also shows that most smokers who start early in life are more likely to die prematurely from smoking-related causes – such as lung cancer. But the earlier a smoker quits the less likely this is to happen. Raising the smoking age to 21 (and every year thereafter) would not only prevent more young people from becoming smokers, but it would also prevent the number of people suffering from smoking-related health problems.

Health benefits for everyone

Some critics of the recommendation to raise the age of sale for cigarettes from 18 to 21 and then by one year every year often cite this as "an infringement of civil liberties". Often, people argue that banning cigarette smoking will ultimately lead to a ban of other harmful substances – such as alcohol, or high-sugar foods. But research is clear that while there may be safe consumption levels of alcohol and sugar there's no safe level for smoking.

Every cigarette smoked harms nearly every organ and system in the body. Secondhand and thirdhand smoke (being around surfaces that have been exposed to cigarette smoke, such as furniture) can also cause serious harm to health, even to those who do not smoke cigarettes – including skin cancers and slower wound healing. Taking steps to reduce the number of people in England who smoke would have major health benefits for smokers and non-smokers alike.

While smoking rates are already declining in the UK, it still remains one of the country's biggest preventable killers. While it's unlikely increasing the smoking age will be enough to help the UK become smoke-free by 2030, combining it with other evidence-based measures (such as limiting where people can smoke and raising the cost of tobacco) will be key in achieving this.

Ray Higginson does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.