Increasing the legal age for tobacco purchase should be combined with other measures to reduce smoking rates in young people, argues an expert in The BMJ today.
The proposal from the All Party Parliamentary Group (APPG) on Smoking and Health to increase the legal age from 18 to 21 would make it harder for children to obtain cigarettes and would take the legal age beyond school age, writes Dr Nicholas Hopkinson, a respiratory specialist from Imperial College London and Medical Director of the British Lung Foundation.
Achieving a smokefree generation - where smoking rates are below 5% across all groups in society - is a "key public health goal."
And helping existing smokers to quit is important, says Hopkinson, who is also chair of Action on Smoking and Health (ASH), but "the most vital element is to prevent young people from starting in the first place."
Most smokers start during childhood, and two thirds of those who try smoking will go on to become regular smokers.
"Smoking is a contagious habit, transmitted within peer groups", writes Hopkinson, and the age increase will protect younger children from exposure to older pupils in school who smoke.
And it will also remove a potential source of supply within schools, he adds.
When the UK increased the legal age for tobacco purchase from 16 to 18 in 2007, there was a fall in youth smoking rates, suggesting that a further increase could replicate this.
But the age increase is not the only possible measure proposed by APPG.
A "polluter pays" tax set to raise around £150 million (€173m; $198m) per year from tobacco manufacturers will help to pay for "a revitalised, evidence-based set of tobacco control policies," says Hopkinson.
This could include the introduction of a retail licensing scheme for tobacco products, which could help to limit underage sales. And it would make it easier to ban sales from those who break the law.
What's more, other measures could include further increases in taxes to reduce affordability, spending on mass media education campaigns back to 2008 levels, supporting regional tobacco control bodies that have had a significant impact, and the inclusion of government mandated pack inserts to support quitting.
Polling data shows that these measures are popular among the public, writes Hopkinson, and "as healthcare professionals we should be advocating them," he urges.
"Ministers should seize the opportunity to deliver a healthy legacy," he concludes.