Abstract
ObjectiveTo assess the long-term impact of the increase in age-of-sale of cigarettes from 16 to 18 in England in October 2007.MethodsData were collected between November 2006 and September 2018 on 252,601 participants taking part in a nationally representative survey of adults aged 16+ in England, the Smoking Toolkit Study (STS). We assessed the impact of the introduction of the increase in age-of-sale on prevalence of ever smoking, current smoking, and quit attempts, among 16–17 year olds compared with 18–24 year olds.ResultsFollowing the increase in age-of-sale, there was a declining trend in ever smoking that was greater among 16–17 year olds than 18–24 year olds (OR 0.990 versus OR 0.993; p = 0.019). Data on current smoking were insensitive to detect a difference between the age groups in a step-level change or change in trend following the increase in age-of-sale (Bayes factors (BFs) 0.75 and 2.10). Data on quit attempts were also insensitive to detect a change in trend (BF 0.71), and despite a greater step-level decline among those aged 16–17 (OR 0.311 versus OR 0.547, p = 0.025), quit attempts remained higher among those aged 16–17. Secondary analysis indicated that post-policy change, trends in current and ever smoking were linear for 16–17 year olds but quadratic for 18–24 year olds (slowing decline).ConclusionThere is some evidence from an assessment of long-term trends in the Smoking Toolkit Study that the increase in legal age-of-sale of cigarettes in England was associated with a greater long-term decline in ever smoking among those aged 16–17 compared with those aged 18–24.
Highlights
A majority of smokers in the UK report that they began smoking before the age of 18, with the mean age of onset of regular smoking being 16 years [1]
This paper considers the impact of the increase in age-of-sale restrictions in England from 16 to 18 on long-term trends in current smoking, ever smoking, and attempts to quit among young people
Millett et al [6] looked at changes over time and accounted for secular trends, their analysis focused solely on 11 to 15 year olds meaning it was not possible to test for differences between age groups for whom buying cigarettes did or did not remain legal
Summary
A majority of smokers in the UK report that they began smoking before the age of 18, with the mean age of onset of regular smoking being 16 years [1]. Millett et al [6] looked at changes over time and accounted for secular trends, their analysis focused solely on 11 to 15 year olds meaning it was not possible to test for differences between age groups for whom buying cigarettes did or did not remain legal. They did not adjust for population-level policies or seasonality, and the annual nature of data collection meant it was not possible to do a more fine grained analysis in the months immediately after the rise in age-of-sale
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