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2 <br />Lowering Initiation Rates <br />The initiation age of tobacco use is critical. Among <br />adults who become daily smokers, approximately <br />90 percent report first use of cigarettes before <br />reaching 19 years of age, and almost 100 percent <br />report first use before age 26. As mentioned above, <br />FDA cannot raise the MLA nationwide. However, <br />states and localities can set a higher minimum age <br />for their communities. Most states currently set <br />the MLA at 18 years. Four states set it at 19 years, <br />and several localities around the country have <br />raised the minimum age to 21 years. <br /> Based on its review of the literature, the <br />committee concludes that overall, increasing the <br />MLA for tobacco products will likely prevent or <br />delay initiation of tobacco use by adolescents and <br />young adults. The age group most impacted will <br />be those age 15 to 17 years. The committee also <br />concludes that the impact of raising the MLA to <br />21 will likely be substantially higher than raising <br />it to 19. However, the added effect of raising the <br />MLA from 21 to 25 will likely be considerably <br />less. <br /> The parts of the brain most responsible for <br />decision making, impulse control, sensation seek- <br />ing, and susceptibility to peer pressure continue <br />to develop and change through young adulthood, <br />and adolescent brains are uniquely vulnerable to <br />the effects of nicotine. In addition, the majority <br />of underage users rely on social sources—like <br />family and friends—to get tobacco. <br /> Raising the MLA to 19 will therefore not have <br />much of an effect on reducing the social sources <br />of those in high school. Raising the MLA to 21 will <br />mean that those who can legally obtain tobacco <br />are less likely to be in the same social networks <br />as high school students. In the same vein, increas- <br />ing the MLA from 21 to 25 is not likely to achieve <br />additional notable reductions in social sources for <br />those under age 15. <br />Reducing Prevalence, Decreasing <br />Disease <br />Delaying initiation rates will likely decrease the <br />prevalence of tobacco users in the U.S. popula- <br />tion. To quantify this decrease in both prevalence <br />of tobacco users and in related health concerns <br />FIGURE: Committee Estimates Regarding Effects on Initiation Rates <br />NOTE: This figure was created using data from Table 7-2 in the report. <br />5% <br />10% <br />15% <br />20% <br />25% <br />30%MLA 25 <br />MLA 21 <br />MLA 19 <br />21-24 yrs19-20 yrs18 yrs15-17 yrsunder 15 yrs <br />Age GroupDecrease in Initiation Rate100%