Tobacco use in Massachusetts 2020

• In 2018, 13.4% of adults smoked. Nationally, the rate was 16.1%.¹
• In 2019, 5.0% of high school students in Massachusetts smoked cigarettes on at least one day in the past 30 days. Nationally, the rate was 6.0%.²

• In 2018, 5.6% of adults in Massachusetts used e-cigarettes and 2.6% used smokeless tobacco.³
• In 2019, 32.2% of high school students in Massachusetts used electronic vapor products on at least one day in the past 30 days. Nationally, the rate was 32.7%.²
• In 2019, 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 3.8%.²
• In 2019, 5.1% 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 5.7%.²

• Massachusetts received $836 million (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2020.⁴
• Of this, the state allocated $4.6 million in state funds to tobacco prevention in fiscal year 2020, 6.9% 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 $1.82. (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

Flavor restrictions

• The sale of all flavored tobacco products is prohibited, except in smoking bars. Smoking bars, which include cigar lounges and hookah bars, are establishments that exclusively occupies an enclosed indoor space and is primarily engaged in the retail sale of tobacco products for consumption by customers on the premises.¹⁰

Licensing laws

• Retailers and wholesalers are required to obtain a license to sell tobacco products.⁶
• A license is required to sell e-cigarette products.⁹
• The sale of tobacco products in pharmacies is prohibited.¹¹

Youth access laws

• 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

• The CDC estimates 51.7% of daily adult smokers in Massachusetts quit smoking for one or more days in 2018.³
• In 2014, the Affordable Care Act required that Medicaid programs cover all tobacco cessation medications.^7**
• Massachusetts’s state quit line invests $1.04 per smoker, compared to the national average of $2.14.⁷
• Massachusetts does have a private insurance mandate provision for cessation.⁷

Updated August 2020

*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, 2018.

2. CDC, Youth Risk Behavioral Surveillance System, 2019.

3. CDC, Behavioral Risk Factor Surveillance System, State Tobacco Activities Tracking and Evaluation System, 2020.

4. Campaign for Tobacco-Free Kids, Broken Promises to Our Children: a State-by-State Look at the 1998 State Tobacco Settlement 21 Years Later FY2020, 2019.

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, 2020.

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

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. Accessed.

10. Truth Initiative, Local restrictions on flavored tobacco and e-cigarette products. https://truthinitiative.org/research-resources/emerging-tobacco-products/local-restrictions-flavored-tobacco-and-e-cigarette.

11. Americans Nonsmokers' Rights Foundation. Municipalities with Tobacco-Free Pharmacy Laws. http://no-smoke.org/pdf/pharmacies.pdf. Accessed.

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

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