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New Hampshire, which imposes a per-pack tax of $1.78, is likely the source of many illicit cigarettes consumed in Massachusetts, the Mackinac Center study said

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And thats creating a confusing picture for researchers: A 2018 report from the National Academy of Sciences that attempted to synthesize all of the studies available up to that time stated there was moderate evidence that e-cigarettes were effective as a smoking cessation tool but noted there was a discrepancy between randomized trials where the effect was evident, and observational surveys where it was not

which later amounted to the largest civil settlement in United States history

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