In 2005, Needham became the first town in the country to raise the age from 18. In research led by the Education Development Center in Waltham, Mass., and published June 12 in the journal Tobacco Control, the authors compared teen smoking rates in the town and 16 others nearby between 2006 and 2010. They found that the prevalence of teen smoking in Needham dropped from 13 percent to 7 percent, a significantly greater drop than in the surrounding area where smoking fell from 15 percent to 12 percent.

Since 2012 some other communities have followed suit. If every town made the change and achieved the same result, Buka said, the health benefits would be huge.

“Teen smoking rates were cut in half after this law was introduced in Needham,” he said. “Nationwide, that would result in 3 million fewer youth who would die early from a smoking related disease. These findings suggest one of the best possible strategies to reduce smoking related diseases, the leading cause of preventable death in the United States.”