Year of Publication



Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Keith Knapp, PhD

Committee Member

Joseph Benitez, PhD

Committee Member

Teresa Waters, PhD


Introduction: Tobacco use is the number one cause of preventable death in the United States with roughly 500,000 premature deaths a year and 3,200 youth smoking their first cigarette daily. On December 20, 2019, President Trump signed legislation to raise the federal minimum age of sale of tobacco products from 18 to 21 years, effective immediately. Prior to this recent regulation, over half of the US population was enforcing this age restriction. The objective of this research is to investigate the impact of tobacco 21 laws on tobacco use and project the national tobacco impact by using the state experiences with tobacco 21 laws.

Methods: The data was obtained from four separate state health departments in Hawaii, California, Oregon, and Maine. Data were taken from two surveys, one that was before the implementation of a Tobacco 21 statewide law, and the other was taken a full year after the regulation was in effect. The data is specifically focusing on youth tobacco use, and the information from these sources were from a youth health survey administered to high schoolers grades 9-12. With these answers, the researcher was able to compare the results from the two surveys within each state to determine the change and the specifics of those changes.

Results: In all four states, there is roughly a 50/50 split with males and females, with the same majority of ethnic groups. Males are mostly smoking. In all four states, cigarette, cigar, and smokeless tobacco use decreased, while e-cigarette use increased. Combined tobacco use varied with an increase in Hawaii & Oregon, and a decrease in California and Maine. There are more tobacco users in rural areas and fewer users after Tobacco 21 implementation.

Conclusion: The states in this paper have laid down the groundwork for the states that are following with similar policies and likewise the federal legislation enacted in December 2019. The goal was to observe the change of tobacco use in high school students, types of tobacco, and urban/rural use. The states’ experiences were also used to project what the national impact would be. The data provides information on where the policies have been successful and where they have not and need to be further improved. This project data is evidence that Tobacco 21 is effective and a crucial part of public health.

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