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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 Quitting statistics and benefits Quitting statistics in Massachussets 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** Massachusettss 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 Notes and references Updated April 2019 *National and state-level prevalence numbers reflect the most recent data available

Protamines Unlike histones and transition proteins, the effects of nicotine on protamines have been extensively studied (Table 2)

Individuals with asthma or weakened immune systems are at even greater risk

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In 2017, Clean Ocean Action volunteers found 29,000 cigarette butts, 7,172 cigar tips, 1,900 empty cigarette packs, and 1,150 lighters