Tobacco use in Massachusetts 2023

• In 2022, 10.4% of adults in Massachusetts smoked. Nationally, adult smoking prevalence was 14.0%.¹
• In 2021, 3.5% of high school students in Massachusetts smoked cigarettes on at least one day in the past 30 days. Nationally, the rate was was 3.8%.²

• In 2022, 5.6% of adults in Massachusetts used e-cigarettes. Nationally, adult e-cigarette use prevalence was 7.7%³
• In 2021, 2.2% of adults in Massachusetts used smokeless tobacco every day or some days. Nationally, adult smokeless tobacco use prevalence was 3.4% ¹
• In 2021, 17.2% of high school students in Massachusetts used electronic vapor products on at least one day in the past 30 days. Nationally, e-cigarette use prevalence among high school students was 18%.²

• Massachusetts received $691.5 million (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2022.⁴
• Of this, the state allocated $6.1 million in state funds to tobacco prevention in fiscal year 2022, 9.2% of the Centers for Disease Control and Prevention’s annual spending target.⁴
• Smoking-caused health care costs: $4.74 billion per year.⁴
• Smoking-caused losses in productivity: $7 billion per year.⁵

Tobacco taxes

• Massachusetts is ranked 6th in the U.S. for its cigarette tax of $3.51 per pack (enacted July 2013), compared to the national average of $1.93. (New York has the highest tax at $5.35 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
• Free distribution or samples of electronic smoking devices is prohibited, as is the distribution of free samples in commercial establishments (except retail tobacco stores or smoking bars).⁹
• Mail-order or internet sales of electronic smoking devices is prohibited unless the retailer requires age-verification and signature by a person of legal sales age upon receipt.⁹

Local tobacco laws

• Brookline prohibits the sale of tobacco or e-cigarette products to anyone born after January 1, 2000.¹²
• Bellingham, Blackstone, Deham, and Hull prohibit the sale of all e-cigarettes. Malden prohibits the sale of all e-cigarettes, except in adult-only retail tobacco stores.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.¹³

• The CDC estimates 44.8% of daily adult smokers in Massachusetts quit smoking for one or more days in 2019.³
• In 2014, the Affordable Care Act required that Medicaid programs cover all tobacco cessation medications.^7**
• Massachusetts’s state quit line invests $1.38 per smoker, compared to the national median of $2.37⁷
• Massachusetts does have a private insurance mandate provision for cessation.⁷

Updated June 2023

* The datasets for both adults and youth prevalence were used to make direct comparisons at the state and national levels. National prevalence reported here may differ from what is reported in our national-level fact sheets. The numbers here also reflect the most recent data available. Dates of available data 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, 2022.

2.         CDC, Youth Risk Behavioral Surveillance System, 2021.

3.         CDC, Behavioral Risk Factor Surveillance System, State Tobacco Activities Tracking and Evaluation System, 2021.

4.         Campaign for Tobacco-Free Kids, Broken Promises to Our Children: a State-by-State Look at the 1998 State Tobacco Settlement 24 Years Later FY2023, 2023.

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, 2023.

8.         Campaign for Tobacco-Free Kids. State Cigarette Excise Tax Rates & Rankings. https://www.tobaccofreekids.org/assets/factsheets/0097.pdf. Accessed October 4th, 2023.

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 October 4th, 2023.

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. Accessed October 4th, 2023.

11.       Americans Nonsmokers' Rights Foundation. Municipalities with Tobacco-Free Pharmacy Laws. http://no-smoke.org/pdf/pharmacies.pdf. Accessed October 4th, 2023.

12.       The Commonwealth of Massachusetts Office of the Attorney General. Brookline Special Town Meeting of November 17, 2020 -- Case # 10029. https://2bark924ef5o2dk1z21reqtf-wpengine.netdna-ssl.com/wp-content/uploads/2021/07/Brookline-10029_-Art-14-_APP-.pdf. Published July 19, 2021. Accessed October 4th, 2023.

13.       Knock Tobacco Out of the Park. https://tobaccofreebaseball.org/. Accessed October 4th, 2023.