Policy Tip Sheet: Tobacco Harm Reduction 101: Massachusetts

Published January 7, 2020

Since their introduction to the U.S. market in 2007, e-cigarettes and vaping devices—tobacco harm reduction products that are 95 percent safer than combustible cigarettes—have helped more than three million American adults quit smoking.

1. Economic Impact
According to the Vapor Technology Association, in 2018, the industry created 1,425 direct vaping-related jobs, including manufacturing, retail and wholesale jobs in Massachusetts, which generated $54 million in wages alone.[1] Moreover, the industry has created hundreds of secondary jobs in Massachusetts, bringing the total economic impact in 2018 to $333,428,500. In the same year, Massachusetts received more than $183 million in state taxes attributable to the vaping industry. These figures do not include sales in convenience stores, which sell vapor products including disposables and prefilled cartridges. In 2016, sales of these products in Massachusetts eclipsed $18.8 million.[2]

2. State Health Department Data
As of December 26, 2019, the Massachusetts Department of Public Health (MDPH) has reported 105 cases of vaping-related lung illnesses.[3] MDPH has provided detailed information on the cases, including age statistics, gender, and substances vaped. According to MDPH, 55 percent of patients are over the age of 30 and 52 percent of cases are female. Further, 60 percent of patients reported vaping tetrahydrocannabinol (THC). The Heartland Institute gives MDPH a grade of A for information available on vaping-related lung illnesses

3. More Information Needed
The most recent report on youth tobacco use in Massachusetts comes from the Massachusetts 2017 Youth Risk Behavior Survey.[4] According to those results, in 2017, 20.1 percent of Massachusetts high school students reported current use of e-cigarettes, or using an e-cigarette at least once in the 30 days prior to the survey. Further, only 2.1 of high school students reported using vaping products daily. More . More data is needed to understand the effects of public health campaigns on youth e-cigarette use.

4. Youth Sales Miniscule
From January 1, 2018 to September 30, 2019, the U.S. Food and Drug Administration (FDA) administered 10,524 tobacco age compliance inspections in Massachusetts, in which the agency used a minor in an attempt to purchase tobacco products.[5] Of those, only 646, or 6 percent, resulted in a sale to a minor. Of the violations, 254 (2 percent of all compliance checks) involved the sale of e-cigarettes or vaping devices. The number of violations involving sales of cigars and cigarettes were 160 and 226, respectively, during the same period.

5. Misspent Money
In 2019, Massachusetts received an estimated $645.5 million in tobacco taxes and tobacco settlement payments. In the same year, the state spent only $4.2 million, or less than 1 percent, on funding tobacco control programs, including education and prevention.[6] Massachusetts invests $1.37 per smoker in the state’s quit line, compared to the national average of $2.21 per smoker. 

Policy Solution
Electronic cigarettes and vaping devices have proven to be tremendous tobacco harm reduction tools, helping many smokers transition away from combustible cigarettes. Despite recent fearmongering, their use is significantly safer than traditional cigarettes, as noted by numerous public health groups including the Royal College of Physicians,[7] Public Health England,[8] and the American Cancer Society.[9] Rather than restricting their use, and undoubtedly reducing public health gains and millions of dollars in economic output, lawmakers should dedicate existing tobacco funds on programs that actually reduce youth use.


Key Points:
1. Massachusetts’s vaping industry provided more than $333 million in economic activity in 2018 while generating 1,425 vaping-related jobs. Sales of disposables and prefilled cartridges in Massachusetts exceeded $18.8 million in 2016.

2. As of December 26, MDPH has reported 105 cases of vaping-related lung illnesses and includes information on age, gender, and substances vaped. 60 percent of Massachusetts patients reported vaping THC. MDPH earns an A-ranking for its reporting on vaping-related lung illnesses.

3. In 2017, only 2.1 percent of Massachusetts high school students reported daily use of vapor products. More data is needed.

4. Only 2 percent of FDA retail compliance checks resulted in sales of e-cigarettes from January 1, 2018 to September 30, 2019.

5. Massachusetts spends very little on tobacco prevention. In 2019, Massachusetts dedicated only $4.2 million on tobacco control, or less than 1 percent of what the state received in tobacco settlement payments and taxes.



[1] Vapor Technology Association, “The Economic Impact of the Vapor Industry MASSACHUSETTS,” 2019, https://vta.guerrillaeconomics.net/reports/5ae23853-f65d-416e-b5e4-9f52f03e63f3?.

[2] Teresa W. Wang et al., “National and State-Specific Unit Sales and Prices for Electronic Cigarettes, United States, 2012-2016,” Preventing Chronic Disease, Centers for Disease Control and Prevention, August 2, 2018, https://www.cdc.gov/pcd/issues/2018/17_0555.htm.

[3] Massachusetts Department of Public Health, “Vaping-Associated Pulmonary Injury Weekly Update Report,” December 26, 2019, https://www.mass.gov/info-details/vaping-associated-pulmonary-injury-weekly-update-report-december-26-2019.

[4] Centers for Disease Control and Prevention, “High School Youth Risk Behavior Survey, Massachusetts 2017 Results,” 2017, https://nccd.cdc.gov/youthonline/App/Results.aspx?LID=MA.

[5] U.S. Food and Drug Administration, “Compliance Check Inspections of Tobacco Product Retailers,” September 30, 2019, https://www.accessdata.fda.gov/scripts/oce/inspections/oce_insp_searching.cfm.

[6] Truth Initiative, “Tobacco use in Massachusetts,” June 28, 2019, https://truthinitiative.org/research-resources/smoking-region/tobacco-use-Massachusetts-2019.

[7] Royal College of Physicians, Nicotine without Smoke: Tobacco Harm Reduction, April 2016, https://www.rcplondon.ac.uk/projects/outputs/nicotinewithout-smoke-tobacco-harm-reduction-0.

[8] A. McNeill et al., “Evidence review of e-cigarettes and heated tobacco products 2018,” Public Health England, February 2018, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/684963/Evidence_review_of_e-cigarettes_and_heated_tobacco_products_2018.pdf.

[9] The American Cancer Society, “What Do We Know About E-Cigarettes?” June 19, 2019,  https://web.archive.org/web/20190806152535/https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/e-cigarettes.html.


For more information, please refer to:

Tobacco Harm Reduction 101: A Guidebook for Policymakers
This booklet from The Heartland Institute aims to inform key stakeholders on the much-needed information on the benefits of electronic cigarettes and vaping devices. Tobacco Harm Reduction 101 details the history of e-cigarettes, including regulatory actions on these products. The booklet also explains the role of nicotine, addresses tax policy and debunks many of the myths associated with e-cigarettes, including assertions about “popcorn lung,” formaldehyde, and the so-called youth vaping epidemic.


Nothing in this Policy Tip Sheet is intended to influence the passage of legislation, and it does not necessarily represent the views of The Heartland Institute. For further information on this and other topics, visit the Budget & Tax News website, The Heartland Institute’s website, and PolicyBot, Heartland’s free online research database.

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