New Report Gives Alabama Failing Grades for Efforts to Prevent Tobacco Use

According to the American Lung Association’s 24th annual “State of Tobacco Control” report, released today, Alabama’s grades show that the state must step up efforts to reduce tobacco use to protect communities. Alabama’s action on tobacco control and prevention is especially critical due to the dramatic rollback of federal tobacco prevention efforts in 2025. 

Tobacco use remains the nation’s leading cause of preventable death and disease, claiming the lives of more than 8,650 state residents each year. The report urges Alabama lawmakers to focus on ensuring the state covers all FDA-approved quit smoking treatments and services to curb tobacco use.

The “State of Tobacco Control” report grades states and the District of Columbia in five areas that have been proven to prevent and reduce tobacco use and save lives. In the 2026 report, Alabama received the following grades: 

1. Funding for State Tobacco Prevention Programs – Grade F
2. Level of State Tobacco Taxes – Grade F
3. Strength of Smokefree Workplace Laws – Grade F
4. 4Coverage and Access to Services to Quit Tobacco – Grade F
5. Ending the Sale of All Flavored Tobacco Products – Grade F 

In 2025, the tobacco control and prevention landscape fundamentally changed when the administration took a series of actions that weakened enforcement and jeopardized public health efforts across the country. These included the virtual elimination of the U.S. Centers for Disease Control and Prevention’s (CDC) Office on Smoking and Health, major staffing cuts to the U.S. Food and Drug Administration’s (FDA) Center for Tobacco Products and delaying Congressionally appropriated funding for nearly six months. As a result, tobacco control and quitline programs in all 50 states and the District of Columbia were left at risk of shutting down, with some states drastically reducing lifesaving services. 

“It is devastating to see the federal government largely abandon its tobacco control efforts. Walking away from the incredible progress the nation has made on reducing tobacco use over the past 50 years is unacceptable,” said Ashley Lyerly, senior director of advocacy at the American Lung Association in Alabama. “States need to ramp up their tobacco prevention efforts even more to protect residents from disease and addiction caused by tobacco use. In 2026, policymakers in Alabama must focus on ensuring the state covers all FDA-approved quit smoking treatments and services and ensure enforcement of existing tobacco control statutes.”

Alabama lawmakers can help residents quit tobacco by covering all quit smoking treatments in its Medicaid program and for state employees. This should include access to all seven FDA-approved tobacco cessation medications and all three forms of counseling without barriers, such as copays and prior authorization. Alabama should also ensure the Quitline has adequate funding, to help people who are un- and under-insured quit.

Federal Grades Overview
The 2026 “State of Tobacco Control” report grades the federal government in five areas: 

• Federal Government Regulation of Tobacco Products – Grade D
• Federal Coverage of Quit Smoking Treatments – Grade D
• Level of Federal Tobacco Taxes – Grade F
• Federal Mass Media Campaigns to Prevent and Reduce Tobacco Use – Grade: I*
• Federal Funding for Tobacco Prevention and Control – Grade: B

*The federal government gets an I for Incomplete in this category due to data not being able to be obtained about the duration, reach and frequency of the Real Cost campaign in 2025.

In the “State of Tobacco Control” report, the American Lung Association calls on the federal government to fully restore critical tobacco control programs, including CDC’s Office on Smoking and Health. Federal leadership is essential. In the current absence of federal leadership, the organization is calling on state legislatures to advance strong, fact-based tobacco control policies that protect communities and reduce tobacco use. 

To learn more about this year’s “State of Tobacco Control” grades and take action, visit Lung.org/sotc.

State grades in “State of Tobacco Control” reflect actions taken by elected officials and do not reflect on the hard work of state tobacco control programs or advocates.