If every state were to immediately ban tobacco sales to those under 21, the smoking rate would fall 12 percent, according to a new report by the Institute of Medicine. The decrease would prevent 249,000 premature deaths among the generation born between 2000 and 2019, the report concludes.

The legal age to buy cigarettes is 18 in most states. Alabama, Alaska, New Jersey and Utah have set the legal age at 19. A total of 58 localities in seven states, including New York City, have banned sales of cigarettes to anyone under 21, USA Today reports.

A 2009 law that gives the Food and Drug Administration (FDA) authority to regulate tobacco forbids the agency from setting a legal purchasing age for tobacco older than 18. The law required the FDA to study the consequences of raising the minimum age.

Of the estimated 249,000 premature deaths prevented by raising the purchasing age, 45,000 would be from lung cancer, the report stated. Raising the purchasing age would also prevent 286,000 premature births, 483,000 cases of low birth weight, and 4,000 cases of sudden infant death syndrome.

The Surgeon General estimates that about 5.6 million young people alive today will die prematurely from smoking. Almost 18 percent of adults, or 42 million Americans, smoke.

Most smokers start using cigarettes before they turn 21, the article notes. According to Matthew Myers, President of the Campaign for Tobacco-Free Kids, increasing the purchasing age to 21 would make it more difficult for teens to get their hands on cigarettes.

“It is hard to imagine a clearer or more convincing message from this report,” Myers said in a statement. He noted that he expects more states and localities to increase the age of sale for tobacco products to 21. Hawaii, California, Washington and New Jersey are considering such legislation.