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See: Statistics from Altmetric.com Introduction Coast-to-coast efforts to combat the tobacco epidemic in the USA since the initial Surgeon Generals report on the consequences of smoking1 have reduced US adult smoking prevalence from 42.4% in 1965 to 15.5% in 2016.2 3 Minnesota has been at the forefront of many tobacco control policies, including being the first state to enact clean indoor air legislation, one of a few states that taxes e-cigarettes as tobacco products and one of the first to sue tobacco companies when it joined with Blue Cross and Blue Shield of Minnesota to recover financial damages from tobacco use in the state, creating public access to internal tobacco company documents in the process.4 Adult smoking prevalence in Minnesota fell from 21.8% in 1997 to 15.2% in 2016.5 These estimates represent 30% declines in per-capita cigarette use in less than 20 years, a substantial public health achievement that sets the stage for improved population health for decades to come