American Lung Association Gives Tennessee Poor Grades for Policies to Prevent Nicotine Use; Must Focus on Requiring Retailers to Obtain Licenses

According to the American Lung Association’s 24th annual “State of Tobacco Control” report, released today, Tennessee’s grades show that the state must step up efforts to reduce nicotine use to protect communities. Tennessee’s actions on nicotine prevention and cessation (including e-cigarettes, pouches) are 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 1,250 state residents each year. The report urges Tennessee lawmakers to focus on requiring all retailers that sell any nicotine products to obtain licenses as a way to curb nicotine 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, Tennessee 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 D
4. Coverage and Access to Services to Quit Tobacco – Grade F
5. Ending the Sale of All Flavored Tobacco Products – Grade F 

In 2025, the tobacco prevention and cessation 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 prevention 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 prevention and cessation efforts. Walking away from the incredible progress the nation has made on reducing tobacco use over the past 50 years is unacceptable,” said Shannon Baker, Director of Advocacy at the American Lung Association in Tennessee. “States need to ramp up their efforts even more to protect residents from disease and addiction caused by nicotine use. 

“In 2026, to address the enormous toll of nicotine on the people of Tennessee, it is critical that policymakers focus on protecting our youth by requiring all retailers that sell any nicotine products to obtain licenses, provide for and fund specific enforcement measures and establish a meaningful penalty structure for underage sales violations,” said Baker. “It is also critical to protect prevention and cessation program funding.” 

Echoing this call for stronger protections, Heidi Huang, an 18-year-old student at Farragut High School and member of youth advocacy group Young Metro Drug Coalition, shared her perspective on how weak enforcement directly affects young people: “I have met people under 21 who have walked into vape shops and bought tobacco products without being carded.  When a store ignores the law, word spreads and other youth start flowing in. I firmly believe stores need to be penalized if they are caught selling products illegally to youth, because when you’re young, that’s when you develop behaviors that can lead to addiction” 

“If you have access to these products when you’re under 21, you’re more likely to continue using them when you’re older. That’s why it’s important these stores are penalized for selling dangerous products to underage people, and why we need stronger retail licensing and enforcement. We also need to protect funding for prevention programs that help youth quit or never start,” said Huang.

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

• Federal 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 management 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 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.