Minimum Age of Sale for Tobacco Products and Electronic Cigarettes: Ethical Acceptability of US "Tobacco 21 Laws".

Several US jurisdictions have recently passed laws that raise the minimum age of sale for tobacco products and electronic cigarettes to 21 years (Tobacco 21 laws). Although these laws have been demonstrated to be an effective means to reduce youth smoking initiation, their passage and potential expansion have provoked controversy. Critics have objected to these laws, claiming that they unduly intrude on individual freedom and that they irrationally and paternalistically restrict the freedom of those aged 18 to 20 years, who were previously able to legally purchase tobacco products. We have examined the ethical acceptability of Tobacco 21 laws. First, we have described ethical support for such a restriction grounded in its public health benefit. We have then offered arguments that raise doubts about the soundness of critics' objections to these regulations and described an additional ethical justification arising from concern about preventing harm to others. On the basis of this analysis, we conclude that Tobacco 21 laws are ethically justifiable.