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However, municipalities may establish a higher minimum legal age of sale

There is a well-established association between cigarette smoking and mental disorders (e.g., major depressive disorder and schizophrenia),[1] with 36% of persons with mental health diagnoses versus just 19% of the United States (U.S.) general population being smokers.[2] Similarly, persons who abuse alcohol, marijuana or hard drugs are likely to smoke cigarettes,[36] with 70% of persons who received past year treatment for substance abuse being smokers.[7] Persons with mental health and substance abuse problems start smoking at a younger age[8] and have higher levels of dependence,[9, 10] and persons with mental illness smoke 45% of cigarettes in the U.S.[9] Smokers who are mentally ill have higher rates of psychiatric symptoms, more psychiatric hospitalizations and poorer treatment outcomes.[1113] There are also differences in health behaviors, such as smoking, by gender and socioeconomic status