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American Lung Association 'State of Tobacco Control' Report Finds the District of Columbia Earns Above Average Grades in Preventing, Reducing Tobacco Use

While D.C. earns an A for implementation of Tobacco 21, Lung Association calls on officials to help smokers quit and reduce disparities in tobacco use by covering all quit smoking treatments in its Medicaid program to save lives.

(January 30, 2019) - WASHINGTON, D.C.

Tobacco use remains the nation's leading cause of preventable death and disease, taking an estimated 480,000 lives every year. This year's "State of Tobacco Control" report from the American Lung Association finds the District of Columbia had mixed progress on its efforts to reduce and prevent tobacco use. The American Lung Association calls on D.C. officials to do the following in order to save lives: Improve the city's Medicaid coverage for tobacco
cessation treatments to be comprehensive and consistent across plans; and fund tobacco prevention and cessation programs at the level recommended by the Centers for Disease Control and Prevention (CDC).

The American Lung Association applauds the District of Columbia for acting to protect youth from tobacco. Youth e-cigarette use is reaching epidemic levels due to a 78 percent increase in high school e-cigarette use from 2017 to 2018, according to results from the Centers for Disease Control and Prevention (CDC)'s 2018 National Youth Tobacco Survey. This equals one million additional kids beginning to use e-cigarettes, placing their developing bodies and lungs at risk from the chemicals in e-cigarettes as well as a lifetime of addiction to a deadly product. This has caused the U.S. Surgeon General to declare e-cigarette use among young people an epidemic in an Advisory issued in December 2018.

"In the District of Columbia our adult smoking rates remain at 14.3 percent. Tobacco use is a serious addiction and we need to invest in the proven measures to prevent and reduce tobacco use outlined in 'State of Tobacco Control'," said American Lung Association's Lance Boucher, Eastern Division Senior Director, State Advocacy. "The report provides a roadmap on how to save lives, but much work remains to be done in communities across D.C. to prevent and reduce tobacco use."

The 17th annual "State of Tobacco Control" report grades states and the federal government on policies proven to prevent and reduce tobacco use, and finds that while D.C. has taken significant steps to reduce tobacco use, by doing things like including funding in its budget this year to implement Tobacco 21 legislation originally approved in 2016, elected officials must ensure all District of Columbia residents benefit from reductions in tobacco use:

  • Funding for State Tobacco Prevention Programs – Grade F
  • Strength of Smokefree Workplace Laws - Grade A
  • Level of State Tobacco Taxes - Grade A
  • Coverage and Access to Services to Quit Tobacco - Grade D
  • Minimum Age of Sale for Tobacco Products to 21 – Grade A

The American Lung Association encourages D.C. to fully fund tobacco control efforts at levels recommended by the CDC, and, this year's report specifically noted the need to focus on improving the city's Medicaid coverage for tobacco cessation treatments to be comprehensive and consistent across plans; and restrict the sale of flavored tobacco products, including menthol in the city.

If D.C. would increase funding for tobacco control programs, they would have a powerful opportunity to help further reduce and prevent tobacco use, including supporting communities that still use tobacco at higher rates and who have been targeted by the tobacco industry. An investment in prevention is especially important given the skyrocketing number of youths who are using e-cigarettes. Despite D.C. receiving 72.9 million dollars from tobacco settlement payments and tobacco taxes, the state does not fund tobacco control efforts at levels recommended by the Centers for Disease Control and Prevention (CDC).

"This year marks the 20th anniversary of the largest legal settlement in U.S. history – the tobacco Master Settlement Agreement. The District of Columbia receives millions of dollars every year from this settlement, and we believe the funds should be used to support the health of our communities, and to help smokers quit and prevent tobacco use," said Boucher.

The U.S. Surgeon General has concluded there is no safe level of exposure to secondhand smoke, and the Lung Association was excited to see that the District of Columbia received an 'A' in this category, passing a comprehensive smokefree law that eliminates smoking in all public places and workplaces, so that workers across the state would benefit. This health protection benefits everyone and is especially critical for those who work in the service and manufacturing sectors who are often exposed to secondhand smoke daily.

Nearly seven out of 10 smokers want to quit, but tobacco use is a serious addiction and quitting can be difficult. Evidence suggests that the number of people quitting smoking increased when coverage for tobacco treatments provides access to all seven FDA-approved tobacco cessation medications and all three forms of counseling without barriers, such as copays and prior authorization. District of Columbia lawmakers have a powerful opportunity to help smokers quit and reduce disparities in tobacco use by covering all quit smoking treatments in its Medicaid program.

"Covering quit smoking treatments in D.C. is the correct and smart choice. Not only will it help smokers quit and save lives, but it will also cut healthcare costs – a win-win for the health of D.C. residents and the economy," said Boucher.

Tobacco is a highly addictive product, and close to 95 percent of smokers try their first cigarette by the age of 21. That's why the Lung Association applauds D.C. lawmakers for not only passing Tobacco 21 legislation, but also for finding the funds to implement the legislation. Tobacco 21 is a powerful tool that increases the minimum age of sale for tobacco products – including e-cigarettes - to 21.

"Virtually all adult smokers had their first cigarette before age 21, and most before the age of 18, but we are changing this in D.C. by increasing the age of sale for tobacco products to at least 21 years old. This move significantly reduces youth tobacco use, slows the e-cigarette epidemic and will save thousands of lives," said Boucher. "Nationwide, increasing the age of sale of tobacco to 21 would prevent 223,000 deaths among people born between 2000 and 2019, including 50,000 fewer dying from lung cancer – the nation's leading cancer killer."

The "State of Tobacco Control" 2019 provides a blueprint that states, and the federal government can follow to put in place proven policies that will have the greatest impact on reducing tobacco use and exposure to secondhand smoke in the U.S.

For media interested in speaking with an expert about the "State of Tobacco Control" report, lung health, tobacco use and tobacco control policies, contact the American Lung Association's Eastern Division Communications Director Ewa Dworakowski at [email protected] or 717-503-3903.


About the American Lung Association

The American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease, through research, education and advocacy. The work of the American Lung Association is focused on four strategic imperatives: to defeat lung cancer; to improve the air we breathe; to reduce the burden of lung disease on individuals and their families; and to eliminate tobacco use and tobacco-related diseases. For more information about the American Lung Association, a holder of the coveted 4-star rating from Charity Navigator and a Gold-Level GuideStar Member, or to support the work it does, call 1-800-LUNGUSA (1-800-586-4872) or visit:

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