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The Effects of the Tobacco 21 Minimum Legal Sales Age Policy on Respiratory Health

Author

Listed:
  • Emmanuel, Zachariah
  • Emmanuel, Maria
  • Aipoh, Godwin
  • Dickson, Vonke
  • Collins, Emma

Abstract

This paper examines the effects of tobacco restrictions policy on respiratory health. We leverage the heterogeneous timing across states in the adoption of the policy from a sample of 8,175 individuals between the ages of 18 and 21. Using the 2011 to 2019 Behavioral Risk Factor Surveillance System (BRFSS), we estimate the impact of the Tobacco 21 MLSA policy on the prevalence of chronic obstructive pulmonary disease (COPD), a progressive lung condition marked by airflow obstruction due to prolonged exposure to irritants like cigarette smoke and air pollution. We find that the T21 MLSA policy lowered the risk of COPD by 11.4 percentage points, or approximately 6.7%, among young adults between the ages of 18 and 21. In addition, we find that the policy had a greater effect on male, black, and Hispanic populations. We also find the policy to be more effective among 20-year-old unemployed young adults with some college education. These findings suggest that the T21 MLSA policy has effectively reduced respiratory health problems among teenagers and young adults, supporting its public health benefits to society. Therefore, states that are yet to adopt the T21 MLSA policy should consider its potential to decrease the risk of COPD and, ultimately, tobacco-related mortality as a valuable component of their health policy.

Suggested Citation

  • Emmanuel, Zachariah & Emmanuel, Maria & Aipoh, Godwin & Dickson, Vonke & Collins, Emma, 2025. "The Effects of the Tobacco 21 Minimum Legal Sales Age Policy on Respiratory Health," MPRA Paper 124996, University Library of Munich, Germany, revised 11 Jun 2025.
    • Handle: RePEc:pra:mprapa:124996
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    References listed on IDEAS

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    1. Frank A. Sloan & Jan Ostermann & Christopher Conover & Donald H. Taylor, Jr. & Gabriel Picone, 2006. "The Price of Smoking," MIT Press Books, The MIT Press, edition 1, volume 1, number 0262693453, December.
    2. Clément de Chaisemartin & Xavier D'Haultfœuille, 2020. "Two-Way Fixed Effects Estimators with Heterogeneous Treatment Effects," American Economic Review, American Economic Association, vol. 110(9), pages 2964-2996, September.
    3. Erica Louis Mtenga & Michael F. Pesko, 2024. "The effect of vertical identification card laws on teenage tobacco and alcohol use," Health Economics, John Wiley & Sons, Ltd., vol. 33(11), pages 2525-2557, November.
    4. Calvin Bryan & Benjamin Hansen & Drew McNichols & Joseph J. Sabia, 2020. "Do State Tobacco 21 Laws Work?," NBER Working Papers 28173, National Bureau of Economic Research, Inc.
    5. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.
    6. Abouk, Rahi & De, Prabal K. & Pesko, Michael F., 2024. "Estimating the effects of tobacco-21 on youth tobacco use and sales," Journal of Health Economics, Elsevier, vol. 94(C).
    7. Rahi Abouk & Scott Adams, 2017. "Compliance Inspections of Tobacco Retailers and Youth Smoking," American Journal of Health Economics, MIT Press, vol. 3(1), pages 10-32, Winter.
    8. Bo Feng & Michael F. Pesko, 2019. "Revisiting the Effects of Tobacco Retailer Compliance Inspections on Youth Tobacco Use," American Journal of Health Economics, MIT Press, vol. 5(4), pages 509-532, Fall.
    9. Sun, Liyang & Abraham, Sarah, 2021. "Estimating dynamic treatment effects in event studies with heterogeneous treatment effects," Journal of Econometrics, Elsevier, vol. 225(2), pages 175-199.
    10. Apollonio, D.E. & Glantz, S.A., 2016. "Minimum ages of legal access for tobacco in the United States from 1863 to 2015," American Journal of Public Health, American Public Health Association, vol. 106(7), pages 1200-1207.
    11. Callaway, Brantly & Sant’Anna, Pedro H.C., 2021. "Difference-in-Differences with multiple time periods," Journal of Econometrics, Elsevier, vol. 225(2), pages 200-230.
    12. Bo Feng & Michael F. Pesko, 2019. "Revisiting the Effects of Tobacco Retailer Compliance Inspections on Youth Tobacco Use," American Journal of Health Economics, University of Chicago Press, vol. 5(4), pages 509-532, Fall.
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    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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