Effective June 9, the legal age to smoke in California was raised from 18 to 21. California followed the lead of Hawaii. The Aloha State had said goodbye to adults under 21 being able to purchase cigarettes in January.

The two states are the first in the U.S. to raise the legal sale age of tobacco products to 21, and they hope doing so will curb youth smoking rates and boost public health numbers. Will it work? Evidence at the local level indicates that it should.

As of today, at least 185 local municipalities in 14 different states had raised the minimum legal sale age for tobacco products to 21. The first to do so was Needham, Massachusetts, with a gradual change between 2005 and 2008.

The changes in Needham have produced results. Data from the Massachusetts Department of Public Health, Tobacco Control Program in 2007 shows:

• The smoking rate for adults in Needham is 56 percent lower than the overall rate for Massachusetts
• The rate of illegal sales to minors (those under age 18) is 79 percent lower in Needham compared to the state of Massachusetts
• The rate of smoking during pregnancy in Needham is 90 percent lower
• Mortality from lung cancer is 24 percent lower among males in Needham
• Mortality from lung cancer is 33 percent lower among females in Needham
• The rate of hospitalizations for lung cancer is 31 percent lower among females in Needham
• The rate of hospitalizations for lung cancer is 21 percent lower among males in Needham

California is hoping for similar change, but the new laws are creating some difficulty.

April Roesler, branch chief of California Tobacco Control Program, estimates the state currently has 240,000 people between the ages of 18 and 21 who smoke. And 34,000 Californians die each year from smoking-related diseases.

In order to prepare those in the retail tobacco industry for the law, the state developed educational and training materials. This included instructions and more efficient means to check age identifications and self-paced Powerpoint training courses. The state made signs and window sign/clings available to retailers.

In Hawaii, the protection of young lungs has not stopped with the legal age change. Recently, the Island of Kauai County Council approved a bill that prohibits smoking in cars with children under the age of 13 in an effort to protect children from secondhand smoke.

Many other counties as well as several states across the United States have banned smoking in cars occupied by children. California has had such a law since 2008, and it restricts smoking in cars with anyone under the age of 18 as an occupant. California's law — along with Oregon's — is considered to be the strictest because of the older age of 18.

Creating barriers by raising the legal age to obtain tobacco will reap benefits for the public in general. Limiting children and adolescents' exposure to the tobacco smoke of others will also contribute to the overall public welfare and health of children, adolescents and adults.

Together, these restrictions prevent children and adolescents from exposure to smoking — either their own or from others — which is a big step toward preventing future health problems.