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adults, including 70% of current smokers support the policy 260+ cities in 18 states and the entire states of Hawaii, California, New Jersey, Maine, and Oregon 1/3 of Missouris population is covered by a Tobacco 21 policy The Health Impact of Increasing the Sale Age of Tobacco: Reduce overall smoking rates by 12% Decrease smoking initiation among 15-17-year-old by 25% and among 18-20 year olds by 15% Fewer smokers before 18 lead to fewer long-term smokers Thousands of lives saved of youth today in Missouri Endorsing Organizations Prevention of Youth Tobacco Use Resources Webinar WEBINAR: TOBACCO 21 LANDSCAPE: FOR MISSOURI AND BEYOND Held September 17, 2018 Tobacco remains the leading cause of behavioral death in the nation, yet little has evolved in the way we combat this health issue

2 March 2018

Of note, electronic cigarettes are unlikely to be a trigger for smoking initiation or relapse among adults in the US.11 A low prevalence of cessation among infrequent electronic cigarette users has been well-documented in a study of recent smokers in the US.12 Similarly, individuals with a positive history of cardiovascular disease who recently quit smoking or reported a recent quit attempt were more likely to use electronic cigarettes compared with current smokers and those who did not report a quit attempt.13 In the EU, 20% of current smokers, 4.7% of former smokers and only 1.2% of never-smokers reported having used an electronic cigarette

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