At the request of the U.S. Food and Drug Administration (FDA), the Institute of Medicine (IOM) conducted a study to examine the potential public health effects of increasing the minimum legal age (MLA) for purchasing tobacco. Findings suggest that raising the MLA may serve to significantly reduce tobacco use initiation among teens and subsequent adult use. Specifically, raising the MLA to 25 is predicted to result in a 16% decrease in adult tobacco use prevalence among current teens. Raising the MLA to 19 or 21 is projected to result in 3% and 12% decline, respectively. The potential public health implications are notable—raising the MLA to 21 across the U.S. is projected to result in roughly 223,000 fewer premature deaths among individuals born between 2000 and 2019, including 50,000 fewer deaths from lung cancer.