The report concludes that overall, raising the minimum legal age for tobacco products would likely delay or prevent the initial use of tobacco by teens and young adults.
From a health perspective, it notes that “the parts of the brain most responsible for decision making, impulse control, sensation seeking, and susceptibility to peer pressure continue to develop and change through young adulthood, and adolescent brains are uniquely vulnerable to the effects of nicotine.”
The institute’s report also notes that the Federal Drug Administration cannot raise the minimum legal age nationwide; that power resides in state and local government.
Local advocates for raising the age to purchase tobacco to age 21 are planning to approaching Montgomery County municipalities with a similar proposal by next year.
The effort, which was implemented nearly two weeks ago, has so far been considered a success, Barcelo said.
"I emailed RTA this morning to ask how it's going, and their head of security said that since implementation nine days ago, they have received no customer comments, so no negatives," he said.
KPIX notes that opponents of San Francisco’s ordinance argue that since 18-year-olds are adults when it comes to voting, serving in the military, or signing a contract, smoking should be no different. In addition, California residents 18 and older can be prescribed medicinal marijuana from a licensed physician, buy and possess up to a half a pound of marijuana, and grow plants for personal consumption.
Barcelo said that "there's no question" that raising the legal age to purchase would save lives.
"My concern is for the health of our youth, and the impact of their brain development," he said. "When we understand how the brain develops, and how susceptible it is to nicotine especially for those under the age of 21, and we know that the vast majority who are lifetime users of tobacco begin smoking before the age of 21, we can save up to 223,000 lives if we raise the age."
According to the PHDMC's 2014 Community Health Assessment, about 10 percent of Montgomery County children ages 12 to 17 use tobacco, and 8 percent used cigarettes in the past month. About 23 percent of adults currently smoke cigarettes. Statewide, about 22 percent of high school students currently use tobacco products (cigarettes, smokeless tobacco or cigars), according to the 2013 Youth Risk Behavior Survey.
Currently, five cities in Ohio have voted to increase the minimum legal age for purchasing tobacco products to 21, according to the Preventing Tobacco Addiction Foundation. Cleveland became the latest city to raise the age from 18 in December 2015, following Upper Arlington, Bexley, and Grandview Heights in Franklin County, and New Albany in Franklin and Licking Counties.