Newswise — New Brunswick, N.J. - Rutgers researchers, with the aid of a new $3 million National Cancer Institute grant, will be studying the effectiveness of Tobacco 21 laws in the hopes of helping determine how tobacco control policies aimed at young people can be strengthened to improve their health and avoid untimely deaths due to tobacco-related illness.

Tobacco 21 laws raise the legal age to purchase tobacco products to 21 years old. Today, five states and more than 310 cities have enacted this policy, and passage of similar laws is spreading quickly. Because of the novelty of Tobacco 21 laws, however, it is unclear how successful this type of policy change is, researchers say. Using this new grant, researchers from Rutgers School of Public Health, Rutgers Robert Wood Johnson Medical School and Rutgers Cancer Institute of New Jersey will examine how the adoption, implementation and maintenance of these policies impacts public health outcomes, while also using the evidence to determine the impact on racial and ethnic disparities.

More than three years ago, an Institute of Medicine (IOM) report concluded that raising the tobacco age of sale to 21 would increase the age at which young people begin to use tobacco, as well as reduce morbidity and mortality from lung cancer, heart disease and other disorders. Subsequently, Tobacco 21 age of sale laws have rapidly diffused as a tobacco control strategy – New Jersey was the third state to enact a Tobacco 21 law and numerous cities within the state followed in support.  However, little is known about the factors associated with adoption or rejection of Tobacco 21 legislation, nor which policy elements are most effective.

The NCI grant -- led by principal investigators Cristine Delnevo, PhD, director of the Center for Tobacco Studies at Rutgers School of Public Health and co-leader of the Cancer Prevention and Control Research Program at Rutgers Cancer Institute of New Jersey, and Shawna Hudson, PhD, professor and research division chief, Department of Family Medicine and Community Health at Robert Wood Johnson Medical School -- will be the first to gather comprehensive data to examine the process, content, and outcome of Tobacco 21 laws, particularly with regard to racial and ethnic disparities in tobacco use.

“While there has been a rapid diffusion of Tobacco 21 laws in the last few years, it is important to note that early adopters of health policies are often communities with the lowest risk of chronic disease; therefore, where Tobacco 21 laws are passed is an important factor in reducing disparities,” says Dr. Hudson, who is also a research member of Rutgers Cancer Institute of New Jersey and professor of Social and Behavioral Health Sciences in the School of Public Health.

The researchers note that the degree of enforcement of Tobacco 21 laws will likely impact short- and long-term public health outcomes such as access to tobacco for young people and patterns of use. In addition, it is not known how Tobacco 21 laws may impact the trends in tobacco product use across different tobacco products, such as smokeless tobacco and vaping, in addition to cigarettes, demographic groups, or regions of the United States.  

“As momentum for Tobacco 21 laws builds, given the diversity in tobacco product availability, regulation, and use, there is an urgent need to expand the evidence base for Tobacco 21 beyond the IOM report, which focused primarily on cigarettes,” says Dr. Delnevo.  “Modern tobacco use among young people is increasingly complex and characterized by decreased cigarette use, increased use of non-cigarette tobacco product use and poly tobacco use, and so the extent to which Tobacco 21 laws will be effective depends on how they are enforced.”

The funding for the study is a five-year, $3,157,179, R01 grant (1R01CA231139) titled, “Adoption, diffusion, and implementation of Tobacco 21 policies to address health.”


About Rutgers School of Public Health, Center for Tobacco Studies:

Rutgers School of Public Health, Center for Tobacco Studies: For nearly two decades, the Rutgers School of Public Health Center for Tobacco Studies has worked to promote and elevate research in tobacco use, policy, and marketing for the benefit of peer researchers, practitioners, and policy makers. Their mission is to enhance the evaluation and surveillance of tobacco control as well as industry initiatives and strategies, by conducting research studies, that include primary and secondary data collection and analysis and qualitative and quantitative methods, and to translate and disseminate findings to program planners and policy makers. Their team of researchers conducts applied research of high quality, integrity, and innovation. Visit the Center for Tobacco Studies at

About Rutgers Robert Wood Johnson Medical School:

As one of the nation’s leading comprehensive medical schools, Robert Wood Johnson Medical School, a part of Rutgers, The State University of New Jersey, is dedicated to the pursuit of excellence in education, research, health care delivery, and the promotion of community health. With more than 5,500 alumni since the start of its first class in 1966, the medical school has expanded its comprehensive programming and educational opportunities and is at the forefront of innovative curriculum development and a visionary admissions program. It has been recognized by U.S. News & World Report as among the top 100 medical schools in the country for research and primary care. Robert Wood Johnson Medical School and Robert Wood Johnson University Hospital, the medical school’s principal affiliate, comprise one of the nation’s premier academic medical centers. Clinical services are provided by more than 500 faculty physicians in 200+ specialties and subspecialties as part of Rutgers Health, the clinical arm of Rutgers University. Rutgers Health is the most comprehensive academic health care provider in New Jersey, offering a breadth of accessible clinical care throughout the state supported by the latest in medical research and education. For more information about Rutgers Robert Wood Johnson Medical School, visit our website at

About Rutgers Cancer Institute of New Jersey:

Rutgers Cancer Institute, along with its partner RWJBarnabas Health, offers the most advanced cancer treatment options including clinical trials and novel therapeutics such as precision medicine and immunotherapy – many of which are not available at other facilities across the state.  Patients have access to these cutting-edge therapies throughout the state at Rutgers Cancer Institute of New Jersey in New Brunswick, Rutgers Cancer Institute of New Jersey at University Hospital in Newark, as well as at RWJBarnabas Health. Along with world-class treatment, which is often fueled by on-site research conducted in Rutgers Cancer Institute laboratories, patients and their families also can seek cancer preventative services and education resources throughout the Rutgers Cancer Institute and RWJBarnabas Health footprint statewide. To make a tax-deductible gift to support the Cancer Institute of New Jersey, call 848-932-8013 or visit Follow us on Facebook at