Tobacco 21 Fact Sheet

Download the Tobacco 21 Fact Sheet.


TOBACCO 21 – The initiative to raise the tobacco purchase age from 18 to 21

Current tobacco use trends are driving new prevention strategies

  • In Illinois, 4,800 teens become new daily smokers each year.1
  • In suburban Cook County, 29 percent of high school seniors use tobacco products.2
  • While great strides have been made in tobacco prevention, declines in tobacco use rates have slowed and products like cigarillos, hookah, and e-cigarettes are now used at double the rate of cigarettes.2
  • Reducing teens’ access to tobacco products is a proven means to reduce current use and prevent initiation.

The age of 21 is important for prevention

  • 95 percent of smokers start before the age of 21.3
  • The majority of underage tobacco users get their tobacco from a peer; however, 90 percent of those suppliers are themselves under the age of 21.4
  • Drawing the line at 21 gets legal tobacco purchasers out of high schoolers’ social circles.

Tobacco 21 saves lives and improves health

  • The Institute of Medicine (IOM) projects that Tobacco 21 could reduce overall smoking by 12 percent by the time today’s teenagers become adults; the biggest declines in tobacco use would be seen among 15-17 year olds (25%) and 18-20 year olds (15%).5
  • Tobacco 21 would immediately improve community health by reducing premature births, SIDS and deaths due to smoking.

The economic impact of Tobacco 21

  • Economists project that nationally, Tobacco 21 could save $212 billion in medical costs.6
  • Each year, tobacco use costs Illinois $5.49 billion in health care costs, $1.9 billion in Medicaid costs and $5.27 billion in lost productivity.1
  • The impact of Tobacco 21 on retail sales would be minimal since the 18-21 year old age group only accounts for 2 percent of overall tobacco sales.7
  • Applying tobacco economic data to IOM’s projected declines in tobacco use resulting from Tobacco 21, Illinois would save more than $2+ billion dollars in future healthcare costs. This doesn’t even include savings in lost productivity costs, which could be nearly as much.11

Tobacco 21 enjoys broad support across Illinois and the U.S., even from smokers!

  • A 2015 CDC study found that 75 percent of adults support Tobacco 21, including 70 percent of current smokers.8 A recent study also found that 68 percent of 18-24 year olds would support Tobacco 21.9
  • More than 430 cities across 24 states, plus the six states, have enacted Tobacco 21.10
  • In Illinois, Tobacco 21 has already been adopted by over 30 municipalities–covering nearly one third of Illinois–including Evanston, Chicago, Oak Park, Highland Park, Naperville, Deerfield and Maywood, and is being considered by dozens more communities.


1 Campaign for Tobacco-free Kids. (2017). The Toll of Tobacco in Illinois. Available at

2 University of Illinois, Center for Prevention Research & Development. (2016). Illinois Youth Survey. Available at

3 Centers for Disease Control and Prevention. (2014). Youth and Tobacco Use [fact sheet]. Available at

4 Berman, M., Crane, R., Hemmerich, N. (2015). Running the Numbers – Raising the minimum tobacco sales age to 21 will reduce tobacco use and improve public health in Franklin County, Ohio. The Ohio State University, College of Public Health, Columbus, OH.

5 Institute of Medicine of the National Academies. (2015) Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products. Available at

6 Counter Tobacco. (2015). Raising the Minimum Legal Sale Age to 21 [fact sheet]. Available at

7 Winickoff, J.P., Hartman, L., Chen, M.L., Gottlieb, M., Nabi, E., DiFranza, J. (2014). Minimum Retail Impact of Raising Tobacco Sales Age to 21. Am J Pub Health, 104(11): e18-e21.

8 King, B.A., Jama, A.O., Marynak, K.L., Promoff, G.R. (2015). Attitudes toward raising the minimum age of sale for tobacco among U.S. adults. Am J Prev Med, 49(4):583-588.

9 Morain, S.R., Winickoff, J.P., Mello, M.M. (2016). Have Tobacco 21 Laws Come of Age? N Engl J Med, 374: 1601-1604.

10 Campaign for Tobacco-free Kids. (2017). States and Localities that have Raised the Minimum Legal Sale Age for Tobacco Products to 21. Available at

11 Campaign for Tobacco-free Kids. (2017). Comprehensive Statewide Tobacco Prevention Programs Save Money. Retrieved from