Changes in Smoking Prevalence in 16-17-year-old Versus Older Adults Following a Rise in Legal Age of Sale: Findings from an English Population Study

Aim: To assess smoking prevalence before and after the rise in legal age of sale of cigarettes in England and Wales from age 16 to age 18 in October 2007.

Design: A series of monthly cross-sectional household surveys: the 'Smoking Toolkit Study'.

Setting: England.

Participants: A total of 53, 322 adults aged 16 and over interviewed between October 2006 and May 2009, 1136 of whom were aged 16 or 17 years.

Measurements: Change in smoking prevalence from pre- to post-legislation, assessed by self-reported smoking status, among the 16-17-year-old group and older adults.

Findings: The prevalence change following the legislation among those aged 16 and 17 was 7.1 percentage points (denominator=1136) compared with 2.4 percentage points (denominator=52,186) for older adults (odds ratio 1.36, P=0.024, 95% confidence interval=1.04-1.77 for the interaction). There was no difference within older age categories.

Conclusions: There was a greater fall in prevalence in 16-17-year-olds following an increase in age of sale than in older age groups. This provides some support to the view that raising the age of sale can, at least in some circumstances, reduce smoking prevalence in younger age groups.