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Looking at one or a few years of pure data rarely captures the whole story, but by comparing Needhams smoking rates with neighboring towns that did not raise the tobacco age limit to 21using all the years for which there is datadoes show that the age limit of 21 did not lead to Needhams smoking rates declining more than in other towns

Limited coverage for pharmacotherapy and counselling and limited access to primary care could affect feasibility for some people.50 , 51 Acceptability Most people who smoke cigarettes have some interest in quitting, and many have accessed behavioural or pharmacologic cessation assistance.19 , 66 This implies acceptability to people who smoke and to providers, although adverse effects of pharmacotherapy may be a concern for some.67 , 68 Using e-cigarettes for smoking cessation may be acceptable to some people, given that many are already using them for this purpose19 , 66 and because of the benefits of potential cessation compared with harms of continued smoking