As of 2019, tobacco purchases for those under 21 years of age are outlawed nationwide per a federal requirement. While research is ongoing on the effects of this order, early data suggests that these laws have resulted in modest declines in tobacco purchases by minors, and these declines are more pronounced when supported with local legislation. As of October 2021, 30 states, the District of Columbia, and 27 independent jurisdictions within Missouri raised the age of legal tobacco sales and associated enforcement provisions to 21 years old. At publication, no state law in Missouri restricts tobacco purchase to 21 years and older. At least five bills (HB 2463, HB 2786, HB 2883, HB 2903, SB 1158) were introduced in the 2022 Missouri regular legislative session to raise the legal age to sell tobacco or vaping products from 18 to 21 years of age.
- Nearly 11,000 Missourians die every year from tobacco-related diseases, and roughly $3 billion yearly is spent on smoking-related illness, and another $3 billion on smoking-related losses in productivity in Missouri.
- Nearly 1 in 11 Missouri high schoolers smoke cigarettes and 1 in 5 use e-cigarettes, which is estimated to result in the premature death of 128,000 children in the state.
- State laws prohibiting the purchase of tobacco and vape products before the age of 21 have resulted in 2.5 to 3.9 percentage point declines in smoking among 18–20 year olds, as well as 2.8 percentage point drops in 16–17 year olds.
- While a majority of adults support laws that restrict tobacco to those aged 21 years and older, many younger adults (particularly below age 30) perceive e-cigarettes to be less harmful than cigarettes.
- With the recency of the federal requirement for tobacco sales to age 21 and over, research on the magnitude of the positive impact on health and effects of the policy is lacking.
- Given that institutions (worksites, schools, housing, etc.) have variations of culture and acceptability in smoking behaviors, more studies on a wide range of policy options are still needed to determine the best methods at curbing youth tobacco use.