Increasing the age for the legal purchase of tobacco in England: impacts on socio-economic disparities in youth smoking
- 1Department of Primary Care and Public Health, Imperial College, London, UK
- 2Division of Cardiology, Department of Medicine, University of California, San Francisco, California, USA
- 3Center for Tobacco Control Research and Education, University of California, San Francisco, California, USA
- Correspondence to Christopher Millett, Imperial College, 3rd Floor Reynolds Building, St Dunstans Rd, London W6 8RP, UK;
Contributors CM conceived the article. DG, JTL conducted and SAG, CM supervised the statistical analysis. CM wrote the paper and DG, JTL, SAG revised it for important intellectual content. CM will act as guarantor.
- Received 4 November 2010
- Accepted 3 February 2011
- Published Online First 17 April 2011
Background The minimum age for the legal purchase of tobacco increased from 16 to 18 years in England, Scotland and Wales on 1 October 2007. The authors examined the impact of this legislation on disparities in smoking behaviour and access to cigarettes among youth in England.
Methods A multivariate logistic regression analysis was carried out adjusting for secular trends in regular smoking using data from the Smoking, Drinking and Drug Use Survey, a national survey of 11–15 year olds. The primary outcome measure was regular smoking and the predictor variables were the law increasing the minimum age for purchase and eligibility for free school meals (FSM).
Results Increasing the minimum age for purchase was associated with a significant reduction in regular smoking among youth (adjusted OR 0.67; 95% CI 0.55 to 0.81, p=0.0005). This effect was not significantly different in pupils eligible for FSM compared with those that were not (adjusted OR 1.29; 95% CI 0.95 to 1.76, p=0.10 for interaction term). The percentage of pupils who stated that they found it difficult to buy cigarettes from a shop did not increase in those eligible for FSM (25.2% to 33.3%; p=0.21) but did increase significantly in others (21.2% to 36.9%; p<0.01) between 2006 and 2008. No differences in ease of purchase were found between pupils eligible for FSM and those not before or after the legislation (2006: p=0.34, 2008: p=0.55).
Conclusions Increasing the age for the legal purchase of tobacco was associated with reduced regular smoking among youth in England and appeared to have a similar impact in different socio-economic groups.
See Editorial, p 842
Funding CM is funded by the Higher Education Funding Council for England and the National Institute for Health Research. SAG is American Legacy Foundation Distinguished Professor in Tobacco Control; his work on this project was also supported by National Cancer Institute Grant CA-61021. The Department of Primary Care & Public Health at Imperial College is grateful for support from the National Institute for Health Research Biomedical Research Centre Funding scheme, the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care scheme, and the Imperial Centre for Patient Safety and Service Quality.
Competing interests None to declare.
Provenance and peer review Not commissioned; externally peer reviewed.