Goal Area 1: Preventing Initiation of Tobacco Use
The TPCP and the CDC share the goal of reducing the health burdens of tobacco use by preventing the initiation of tobacco use. A related effort in some local and state tobacco prevention programs has been to raise the legal age of purchase from 18 (or 19 in some jurisdictions) to 21 (see https://tobacco21.org/). On December 20, 2019, President Trump signed a bipartisan bill that raised the minimum legal sales age for all tobacco products in the U.S. (including ENDS) to 21 (Carlisle, 2020). On March 13, 2020, Governor Gordon signed a similar law specific to Wyoming (Angell, 2020). This report provides data relevant to this developing issue in tobacco prevention, but all ATS data were collected before these laws took effect.
A key limitation for findings in this section is that many of the relevant survey questions ask about events (such as when someone first smoked a whole cigarette) that happened years before data collection. Therefore, these data are especially subject to memory errors. However, precise recall is not critical to the conclusions in this report.
Age of Smoking a Whole Cigarette for the First Time
Almost all (92%) of the adults who had ever smoked an entire cigarette smoked their first one before the age of 21 (Figure 17). Moreover, the vast majority of them smoked their first cigarette before they were 18, with an average age of 16. This pattern has remained consistent since comparable questions were first asked in 2010.
Age of Initiating Daily Smoking
When people start smoking at a younger age, they are more likely to keep the habit long term (CDC, 2014b). These ATS data show that this holds true for Wyomingites: 88% of regular smokers (current and former smokers; see Table 3) began smoking daily before the age of 21 (Figure 18). Regular smokers are those who had smoked at least 100 cigarettes in their lifetime (Table 3).
A growing public health concern is the link between ENDS use and the initiation of cigarette smoking. Emerging research (such as Berry et al., 2019; Hair et al., 2021) shows that vaping may lead people to smoke. In Wyoming, 73% of regular smokers who reported that ENDS were on the market when they began smoking said that they used ENDS first. This finding is consistent with concerns that vaping may lead to smoking, though it does not directly assess the transition. For a detailed examination of vaping in Wyoming see the ATS Electronic Nicotine Delivery Systems (ENDS) module.
Conclusions
The smoking habits of the vast majority of smokers begin when they are under the age of 21, especially under the age of 18. Relatively few adults begin to smoke after age 21. ATS data on the subject clearly point toward youth being a key factor in the initiation of long-term smoking habits. Further, ATS data are consistent with new research showing that vaping may lead nonsmokers to smoke cigarettes.
