Tobacco use in Massachusetts 2019

• In 2017, 13.7% of adults smoked. Nationally, the rate was 17.1%.¹
• In 2017, 6.4% of high school students in Massachusetts smoked cigarettes on at least one day in the past 30 days. Nationally, the rate was 8.8%.²

• In 2017, 3.3% of adults used e-cigarettes and 2.3% used smokeless tobacco.³
• In 2017, 20.1% of high school students in Massachusetts used electronic vapor products on at least one day in the past 30 days. Nationally, the rate was 13.2%.²
• In 2017, 4.8% of high school students in Massachusetts used chewing tobacco, snuff or dip on at least one day in the past 30 days. Nationally, the rate was 5.5%.²
• In 2017, 6.7% of high school students in Massachusetts smoked cigars, cigarillos or little cigars on at least one day in the past 30 days. Nationally, the rate was 8.0%.²

• Massachusetts received $864.5 million (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2019.⁴
• Of this, the state allocated $4.2 million in state funds to tobacco prevention in fiscal year 2019, 6.3% of the Centers for Disease Control and Prevention’s annual spending target.⁴
• Smoking-caused health care costs: $4.08 billion per year.⁴
• Smoking-caused losses in productivity: $2.40 billion per year.⁵

Tobacco taxes

• Massachusetts is ranked 5th in the U.S. for its cigarette tax of $3.51 per pack (enacted July 2013), compared to the national average of $1.81. (The District of Columbia has the highest tax at $4.50 and Missouri has the lowest at 17 cents.)^6-8
• Little cigars are taxed at $3.51 per 20 cigars. Smokeless tobacco is taxed at 210% of the wholesale price. Cigars and smoking tobacco are taxed at 40% of the wholesale price.^6,7

Clean indoor air ordinances

• Smoking is prohibited in all government workplaces, private workplaces, schools, childcare facilities, restaurants, bars (allowed in smoking bars), retail stores and recreational/cultural facilities.⁷
• E-cigarettes are included in the state’s definition of smoking.⁹

Youth access laws

• The minimum age to purchase tobacco products in Massachusetts is 21. In December 2019, the United States adopted a law raising the federal minimum age of sale of all tobacco products to 21, effective immediately.
• Establishments are required to post signs stating that sales to minors are prohibited.⁶
• Self-service tobacco product displays are prohibited except in adult-only retail stores.⁶

Local tobacco laws

• 144 cities and local municipalities in Massachusetts, including Boston, have restricted flavored tobacco to adult-only retail tobacco stores and/or smoking bars. While a majority of these flavored tobacco laws exempt menthol, mint and wintergreen flavors, Ashland, Needham and Somerville include menthol, mint and wintergreen in their laws.
• 173 cities and towns in Massachusetts, including Boston, require cigars to be sold for at least $2.50 and multi-packs of 2 or more cigars for at least $5.00.¹⁰
• 125 cities and towns in Massachusetts have caps on the number of tobacco licenses.¹⁰
• 186 cities and local municipalities in Massachusetts, including Boston, have adopted laws banning pharmacies from selling tobacco products.¹⁰
• The use of smokeless tobacco and other tobacco products at baseball parks, including Fenway Park, and other professional and amateur sports venues is prohibited.¹¹

• The CDC estimates 48.9% of daily adult smokers in Massachusetts quit smoking for one or more days in 2017.³
• In 2014, the Affordable Care Act required that Medicaid programs cover all tobacco cessation medications.^7**
• Massachusetts’s state quit line invests $1.37 per smoker, compared to the national average of $2.21.⁷
• Massachusetts does not have a private insurance mandate provision for cessation.⁷

Updated April 2019

*National and state-level prevalence numbers reflect the most recent data available. This may differ across state fact sheets.

**The seven recommended cessation medications are NRT gum, NRT patch, NRT nasal spray, NRT inhaler, NRT lozenge, Varenicline (Chantix) and Bupropion (Zyban).
Fiore MC, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: US Department of Health and Human Services. Public Health Service: May 2008.

1. CDC, Behavioral Risk Factor Surveillance System, 2017.

2. CDC, Youth Risk Behavior Surveillance System, 2017.

3. CDC, Behavioral Risk Factor Surveillance System, State Tobacco Activities Tracking and Evaluation System, 2017.

4. Campaign for Tobacco-Free Kids, Broken Promises to Our Children: a State-by-State Look at the 1998 State Tobacco Settlement 20 Years Later FY2019, 2018.

5. Campaign for Tobacco-Free Kids, Toll of Tobacco in the United States.

6. American Lung Association, State Legislated Actions on Tobacco Issues (SLATI).

7. American Lung Association, State of Tobacco Control, 2019.

8. Campaign for Tobacco-Free Kids. State Cigarette Excise Tax Rates & Rankings.  https://www.tobaccofreekids.org/assets/factsheets/0097.pdf.

9. Public Health Law Center. U.S. E-Cigarette Regulation: 50-State Review.  http://www.publichealthlawcenter.org/resources/us-e-cigarette-regulations-50-state-review.

10. Massachusetts Association of Health Boards. Tobacco Maps of Massachusetts.  http://www.mahb.org/tobacco-control/ma-tobacco-maps/.

11. Knock Tobacco Out of the Park.  https://tobaccofreebaseball.org/.