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(The District of Columbia has the highest tax at $4.50 and Missouri has the lowest at 17 cents.)6-8 All other tobacco products are taxed at 75% of the wholesale price.6,7 Clean indoor air ordinances Smoking is prohibited in all government workplaces, private workplaces, schools, childcare facilities, retail stores, bars, restaurants and recreational/cultural facilities.7 Smoking restrictions are not required in casinos/gaming establishments (tribal establishments only).7 E-cigarettes are included in the states clean indoor air law.9 Licensing laws Retailers and wholesalers are required to obtain a license to sell tobacco products.6 Retailers and wholesalers are required to obtain a license to sell e-cigarette products.9 Youth access laws Effective December 2019, the United States adopted a law raising the federal minimum age of sale of all tobacco products to 21

Aggravation of coronary and respiratory disease: The particles can cause flare-ups or worsen problems for people with coronary artery disease, congestive heart failure, or chronic obstructive pulmonary disease (COPD) 13