Panel Urges New Restrictions on Tobacco Access

A panel of experts reviewed the evidence of oral and other health effects associated with tobacco use and said that an increase in the minimum age of legal access to tobacco products will likely prevent or delay initiation of tobacco use by adolescents and young adults with consequent improvements in the public health.

The full benefits of tobacco use prevented will take decades to accrue, the report said. “However, in the absence of transformative changes in the tobacco market, social norms and attitudes, or the epidemiology of tobacco use, the committee is reasonably confident that raising the minimum legal age will reduce tobacco initiation, particularly among adolescents 15 to 17 years of age, will improve health across the lifespan and will save lives”.

A higher minimum legal age would also likely reduce exposure to second hand smoke and the prevalence of other tobacco products, further reducing adverse health effects immediately and over time, the Institute of Medicine committee said in a report supported by a contract between the National Academy of Sciences and the U.S. Food and Drug Administration and addressed to national, state and local policy makers.

The minimum age of legal access to tobacco products was set at 18 by the states more than two decades ago in response to federal incentives and is now required by federal law, although states and localities remain free to raise the age, according to the IOM panel chair.

The American Dental Association is working with policy makers, public health leaders and others to help prevent oral cancer, pharyngeal cancer and other diseases of the mouth associated with tobacco use. Other possible oral health impacts of smoking and use of other tobacco products include stained teeth and tongue, dulled sense of taste and smell, slow healing after a tooth extraction or other surgery, difficulties in correcting cosmetic dental problems, gum disease and bad breath.

The emergence of electronic nicotine delivery systems, including e-cigarettes, is of concern to the ADA and the Institute of Medicine. “The development and marketing of new products is a wild card in the epidemiology of tobacco use”, said the IOM panel of experts in public health, public policy, epidemiology, adolescent and young adult development and risk behaviors and perceptions.

The Association has stated concern about the oral health impact of the latest generation of tobacco products, including e-cigarettes, e-cigarette cartridges, snus, dissolvable tobacco, tobacco gels and more. Visit and the ADA consumer website for more information on Association tobacco policy and tobacco’s effects on the mouth.

© 2017 American Dental Association. All rights reserved. Reproduction or republication is strictly prohibited without the prior written permission from the American Dental Association.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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Tobacco's greatest threat to your health may be its association with oral cancer. The American Cancer Society reports that:

  • About 90 percent of people with mouth cancer and some types of throat cancer have used tobacco. The risk of developing these cancers increases as people smoke or chew more often or for a longer time.

  • Smokers are six times more likely than nonsmokers to develop these cancers.

  • About 37 percent of patients who continue to smoke after cancer treatment will develop second cancers of the mouth, throat or larynx. While only 6 percent of people who quit smoking will develop these secondary cancers.

  • Smokeless tobacco has been linked to cancers of the cheek, gums and inner surface of the lips. Smokeless tobacco increases the risk of these cancers by nearly 50 times.7