20 Years of Tobacco Control in Massachusetts: New Report Shows Continued Progress Depends on Increased Tobacco Control Funding

The American Lung Association’s 20th annual “State of Tobacco Control” report, released today, reveals significant progress in the work to end tobacco use, but products like e-cigarettes and other flavored tobacco products, including menthol cigarettes, create concern for losing another generation to nicotine addiction. The report finds that Massachusetts earned largely good grades on policies to reduce and prevent tobacco use but highlighted one main area of improvement: funding for tobacco cessation and prevention programs. 

The “State of Tobacco Control” report evaluates state and federal policymakers on actions taken to eliminate tobacco use, the nation’s leading cause of preventable death. The report recommends proven-effective tobacco control laws and policies to save lives. The 2022 “State of Tobacco Control” reveals that the country has made substantial progress in advancing tobacco control policies over the past 20 years, including comprehensive smokefree laws in more states, increased tobacco taxes across the nation and more Americans with access to treatments to help them quit smoking through state Medicaid programs. 

Here in Massachusetts over the last 20 years, lawmakers have made significant strides to reduce tobacco use, including a robust clean indoor air act that protects people from secondhand smoke, and the first law to remove all flavored tobacco products - including menthol - from the market. However, there is more work to be done. The high school tobacco use rate is an astounding 37%.  Today, smoking costs the State over $4 billion and the lives of more than 9,000 Massachusetts residents annually.  (This data was collected before the menthol flavored products were removed from shelves.)

“While we have seen considerable progress in Massachusetts, tobacco use remains our leading cause of preventable death and disease, taking an estimated 28,170 lives each year,” said Trevor Summerfield, director of advocacy for the American Lung Association in Massachusetts. “If we want to continue our progress and leadership on tobacco control policy we must do more to prevent youth from initiating tobacco use, help those who want to quit and address the unequal burden of tobacco use in communities experiencing health disparities.”

Massachusetts’s Grades 
“State of Tobacco Control” 2022 grades states and the District of Columbia in five areas that have been proven to prevent and reduce tobacco use and save lives. Massachusetts received the following grades: 

• Funding for State Tobacco Prevention Programs – Grade F
• Strength of Smokefree Workplace Laws – Grade A
• Level of State Tobacco Taxes – Grade B
• Coverage and Access to Services to Quit Tobacco – Grade C
• Ending the Sale of All Flavored Tobacco Products   - Grade A

This year’s report noted the need for Massachusetts policymakers to focus on increasing funding for tobacco prevention and quit smoking programs, including their QUIT line services.  The Massachusetts Tobacco Control Program has seen some recent increases, but further investment could have lifesaving potential given the ongoing youth vaping epidemic. 

“Despite receiving over $686 million from tobacco settlement payments and tobacco taxes, Massachusetts only funds tobacco control efforts at 11% of the level recommended by the Centers for Disease Control and Prevention (CDC). The Lung Association believes the funds should be used to support the health of our communities, and to prevent tobacco use and help people quit, and not switch to e-cigarettes. These programs are also critical for helping to end tobacco-related health disparities,” said Summerfield.

The increased funding could also be paired with an increased tobacco tax – which has been proven to be one of the most effective ways to reduce tobacco use, not only among low-income individuals but also for youth, is to significantly increase the tax on all tobacco products, including e-cigarettes. Multiple studies have shown that every 10% increase in the price of cigarettes reduces consumption by about 4% among adults and about 7% among youth. Massachusetts has not significantly increased its tobacco tax in nearly a decade.

In addition to funding and taxes, the report urges legislators to defend their landmark legislation of flavored tobacco products and avoid any rollbacks.  According to the 2021 National Youth Tobacco Survey, more than two million high school and middle school students use e-cigarettes, and over 80% of those kids use flavored e-cigarettes. In addition, menthol cigarettes continue to be the major cause of tobacco-related death and disease in Black communities, with nearly 81% of Black Americans who smoke using them. Ending the sale of flavored tobacco products, including menthol, will not only help end youth vaping, but will also help address the disproportionate impact of menthol cigarettes and flavored cigars have on many communities, including Black Americans, LGBTQ+ Americans and youth.  

“Massachusetts made history when we ended the sale of all flavored tobacco products and it became a clear leader in public health policy. Defending and maintaining that law, without any loopholes, is a key to ending youth tobacco use in the state,” said Summerfield.

Federal Grades Overview
“State of Tobacco Control” 2022 also grades the federal government in five areas: 

• Federal Government Regulation of Tobacco Products (2022 grade – D)
• Federal Coverage of Quit Smoking Treatments (2022 grade – D)
• Level of Federal Tobacco Taxes (2022 grade – F)
• Federal Mass Media Campaigns to Prevent and Reduce Tobacco Use (2022 grade – A)
• Federal Minimum Age of Sale for Tobacco Products to 21 (2022 grade – I*)

* The Incomplete grade is for the FDA being more than 18 months overdue in publishing the final Tobacco 21 regulations as required by statute.

“In 2022, Massachusetts needs to redouble its efforts to pass the proven policies called for in ‘State of Tobacco Control’ to help end tobacco use. We cannot afford to wait 20 more years and allow another generation to suffer from tobacco-caused addiction, disease and death,” said Summerfield.

For media interested in speaking with an expert about the “State of Tobacco Control” report, lung health, tobacco use and tobacco control policies, contact the American Lung Association at [email protected] or 516.680.8927.