In Japan and Ireland, there are calls to raise the legal age for purchasing tobacco to 21 or even 22.

Politicians and researchers are calling for the legal age for purchasing tobacco products to be raised to 21 in Ireland and 22 in Japan.

At the 2023 European Society of Cardiology (ESC) Congress, held in Amsterdam from 25 to 28 August 2023, a team of Japanese researchers presented a study on the profile of nicotine addiction according to the age of smoking initiation.[1]. A total of 1382 smokers who consulted at a smoking cessation center in Kyoto were divided into two groups, according to whether they started smoking before (n = 556) or after 20 years of age (n = 826), this being the age at which cigarettes can be legally purchased in Japan. Males were the majority in this sample (70 %), reflecting the sex ratio of smoking prevalence in Japan.

Early smokers are more addicted to nicotine

Smokers who started before age 20 smoked more cigarettes per day than smokers who started after age 20 (25 versus 22). They also had higher levels of carbon monoxide (CO) in their exhaled air and scored higher on the Fagerström test, which measures smoking dependence. In addition, only 46% of smokers who started before age 20 managed to quit completely, compared with 56% of those who started after age 20.

"Our results indicate that starting smoking early is linked to stronger nicotine dependence", said Dr. Koji Hasegawa, one of the authors of the study, confirming other studies on the subject. This finding leads him to call on the Japanese authorities to raise the legal age for purchasing tobacco to 22 years - or more.

An essential step towards achieving a Tobacco-Free Generation

In Ireland, where the legal age to buy tobacco is currently 18, Colm Burke, the Fine Gael health spokesman, has called on the government to raise the age to 21.[2]. He notably stressed that in the United States, raising the legal age for purchasing tobacco to 21 in 2016 had reduced the prevalence of smoking among those under 25 by 20%. He also hoped that Ireland, which had introduced a ban on smoking in the workplace in 2004, would remain among the countries most active in the fight against smoking, which has not been the case since 2018.

Colm Burke is calling for this measure to be included in the Public Health (Tobacco and Nicotine Inhaling Products) Bill, a bill currently before Parliament. Alternatively, he suggests amending the Public Health [Tobacco] Act 2002 to include this provision. He has also stressed the need for strong anti-smoking measures to achieve the goal of a Tobacco Free Generation in Ireland by 2025, with fewer than 5,% smokers in the population. In 2020, there were 14,% daily smokers in Ireland.

Raising the age, a measure well understood and well accepted by the population

In these two countries, as in others, raising the legal age for purchasing tobacco would make it possible, on the one hand, to delay the age of smoking initiation, and on the other hand, to limit the intensity of nicotine dependence, which would facilitate weaning and maintaining it. Raising this legal age to 21 instead of 18 is one of the public protection measures envisaged or already implemented in the countries that have made the most progress in the fight against smoking. It is also a measure perceived positively by the population: in the United Kingdom, 64% of adults and 54% of 18-24 year-olds are in favour of such a measure, compared with 15% of adults who are opposed to it.

Keywords: Japan, Ireland, legal age, 21 years, tobacco addiction.

M.F.

[1] Smokers who start below age 20 become more addicted and find it difficult to quit, ESC, published August 25, 2023, accessed August 28, 2023.

[2] Cox J, TD calls for age limit on tobacco products to be increased to 21, Breaking News, published August 27, 2023, accessed August 28, 2023.