This week Cleveland joined the list of more than 100 U.S. cities that have raised the legal age for purchasing tobacco products to 21. Other cities on the list include New York and Kansas City. Hawaii raised the legal smoking age to 21 this summer.

More than 80 communities in Massachusetts have raised the legal age to 21, although the state requirement to purchase cigarettes is 18, Cleveland.com reports. There have been no legal challenges to the changes in Massachusetts so far, the article notes.

In October, the American Academy of Pediatrics called on the U.S. government to raise the legal smoking age to 21 for both traditional cigarettes and e-cigarettes.

Earlier that month, 10 U.S. senators proposed raising the nationwide smoking age to 21. The Tobacco to 21 Act would allow the Department of Health and Human Services to ensure compliance.

The legal age to purchase tobacco is 19 in Alabama, Alaska, New Jersey and Utah. Legislators in Washington state and California have also introduced measures to raise the legal smoking age to 21 in recent months.

The Institute of Medicine issued a report earlier this year that concluded if every state were to immediately ban tobacco sales to those under 21, the smoking rate would fall 12 percent. The decrease would prevent 249,000 premature deaths among the generation born between 2000 and 2019, the report noted.