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We used SAS version 9.3 (SAS <br />Institute, Cary, NC) to conduct <br />data analysis. We calculated mean <br />average daily and annual cigarette <br />consumption for current smokers <br />aged 18 to 20 years and those <br />aged 21 years or older to determine <br />the proportion of total cigarette <br />consumption that is attributable to <br />18- to 20 -year-old smokers. <br />In our sample of 33 014 (Table <br />1), there were 6138 (18.6%) cur- <br />rent smokers, 188 (15.2% smoking <br />prevalence) in the 18- to 20 -year- <br />old group and 5950 (18.7% <br />smoking prevalence) in the group <br />aged 21 years and older. The <br />18- to 20 -year-old group of cur- <br />rent smokers were 49% female, <br />77% White, 18% Hispanic, and <br />16% Black, and the current <br />smokers aged 21 years or older <br />were 48% female, 77% White, <br />12% Hispanic, and 17% Black. <br />PUBLIC HEALTH POLICY BRIEFS <br />About 37% of 18- to 20 -year-old <br />respondents lived with 3 or more <br />household members compared <br />with 4% of those aged 21 years or <br />older (P<.001). <br />Table 2 demonstrates the lower <br />daily cigarette consumption of <br />those aged 18 to 20 years versus <br />those aged 21 years or older <br />(8.6 per day vs 12.5 per day; <br />P<.001). We also found out <br />that 18- to 20 -year-old smokers <br />make up 3.06% of the total <br />adult smoking population but ac- <br />count for just 2.12% of cigarette <br />consumption. <br />If one assumes that the number <br />of cigarettes smoked by 18- to <br />20 -year-old smokers corresponds <br />to the number of cigarettes sold to <br />them or to others on their behalf, <br />the maximum immediate loss of <br />sales would be just 2% of the total <br />cigarette sales in the United States. <br />If we assume that this intervention <br />would have a long-term impact <br />on the prevalence of smoking by <br />adolescents and young adults, the <br />gradual aging of this low -tobacco - <br />use cohort would give plenty of <br />time for small businesses to adjust <br />to changing market conditions <br />were the minimum legal tobacco <br />sales age raised to 21 years. <br />Similar objections were raised <br />decades ago when the national <br />minimum drinking age was pro- <br />posed to be raised to 21 years. <br />After the law was passed and <br />implemented by most states in the <br />1980s, a reduction in drinking, <br />problematic drinking, drinking <br />and driving, and alcohol-related <br />crashes among youths was seen 14 <br />The alcohol industry still survived <br />by adapting to the changing mar- <br />ket despite the loss of sales to <br />those younger than 21 years. Fur- <br />thermore, retailers are already <br />required under federal rules to <br />check the ID of anyone who ap- <br />pears to be younger than 27 years <br />seeking to purchase tobacco,15 <br />so an age -21 requirement would <br />place no additional compliance <br />burdens on their staff. The fact <br />that more than one third of the <br />18- to 20 -year-old young adults <br />live with 3 or more individuals <br />highlights the additional potential <br />for blocking the transfer of to- <br />bacco use behavior to other <br />household members. <br />The evolving neuroscience of <br />the young adult brain demonstrates <br />TABLE 1 -Basic Characteristics of Respondents and Current Smokers: 2011 National Health Interview Survey, United States <br />Respondents Aged 18-20 Years Current Smokers Aged 18-20 Years Respondents Aged >_ 21 Years Current Smokers Aged >_ 21 Years <br />Characteristics (n =1239), No. (%) or Mean ±SD (n =188), No. (%) or Mean ±SD (n = 31775), No. (%) or Mean ±SD (n = 5950), No. (%) or Mean ±SD <br />Gender <br />Male <br />Female <br />Race/ethnicity <br />White <br />Black <br />American Indian/Alaska Native <br />Asian Indian <br />Chinese <br />Filipino <br />Other Asian <br />Not released <br />Multiple race <br />Hispanic <br />Household number per family <br />1 <br />2 <br />3 <br />>_4 <br />Mean ±SD <br />Current smoker <br />610 (49.23) <br />96 (51.06) <br />14 201 (44.69) <br />3112 (52.30) <br />629 (50.77) <br />92 (48.94) <br />17 574 (55.31) <br />2838 (47.70) <br />867 (69.98) <br />144 (76.6) <br />24 207 (76.18) <br />4570 (76.81) <br />245 (19.77) <br />31 (16.49) <br />4948 (15.57) <br />1031 (17.33) <br />22 (1.78) <br />2 (1.06) <br />375 (1.18) <br />108 (1.82) <br />9 (0.73) <br />0 (0) <br />394 (1.24) <br />28 (0.47) <br />19 (1.53) <br />1 (0.53) <br />458 (1.44) <br />35 (0.59) <br />18 (1.45) <br />3 (1.6) <br />450 (1.42) <br />49 (0.82) <br />43 (3.47) <br />6 (3.19) <br />775 (2.44) <br />100 (1.68) <br />4(0.32) <br />0 (0) <br />74 (0.23) <br />8 (0.13) <br />12 (0.97) <br />1 (0.53) <br />94 (0.30) <br />21 (0.35) <br />318 (25.67) <br />33 (17.55) <br />5549 (17.46) <br />721 (12.12) <br />524 (42.29) <br />87 (46.28) <br />257 (20.74) <br />55 (29.26) <br />305 (24.62) <br />34 (18.09) <br />153 (12.35) <br />12 (6.38) <br />2.12 ±1.2 <br />1.88 -±1.07 <br />188 (15.2) <br />Note. The sample size was n = 33 014 participants. <br />22 369 (70.4) <br />4368 (73.41) <br />8159 (25.68) <br />1328 (22.32) <br />841 (2.65) <br />178 (2.99) <br />406(l.28) <br />76 (1.28) <br />1.36 ±0.66 <br />1.33 --±0.66 <br />5950 (18.7) <br />November 2014, Vol 104, No. 11 1 American Journal of Public Health Winickoff et al. I Peer Reviewed I Public Health Policy Briefs I e19 <br />