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The next lowest is Georgia at $0.37/20-pack

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Researchers have found that counterfeit cigarettes can have as much as seven times the lead of authentic brands and close to three times as much thallium, a toxic heavy metal.[19] Other sources report finding insect eggs, dead flies, mold, and human feces in counterfeit cigarettes.[20] During the prohibition of alcohol in the United States during the 1920s, increased enforcement failed to significantly decrease the prevalence of bootlegging because the profit margins were so large and the distribution networks sophisticated

San Mateo Countys Tobacco Retailer Permit Ordinance affects tobacco retailers operating in unincorporated areas of the county and the following cities: San Carlos, San Mateo, Colma, East Palo Alto, Brisbane, Menlo Park, Millbrae, San Bruno, and South San Francisco