New Hampshire Tobacco Control Policies Earn Failing Grades in Effort to Prevent and Reduce Tobacco Use

American Lung Association report reveals best and worst states for tobacco control policies, outlines steps to reduce burden of tobacco in New Hampshire
New Hampshire is listed as one of the states with the worst policies to prevent and reduce tobacco use, according to the American Lung Association’s 21st annual “State of Tobacco Control” report, released today. The state earned mostly failing grades on this year’s report.

The “State of Tobacco Control” report evaluates state and federal policies on actions taken to eliminate tobacco use and recommends proven-effective tobacco control laws and policies to save lives. This is critical, as tobacco use remains the leading cause of preventable death and disease in America and takes the lives of 1,940 New Hampshire residents each year.

“New Hampshire has long lagged behind when it comes to tobacco control policies, and as a result, we have nearly 1 in 3  high school students using tobacco products,” said Lance Boucher, Director of Advocacy at the American Lung Association in New Hampshire. “This gives us an important opportunity to improve health through proven policies, such as increasing funding for our tobacco control and prevention program, increasing the cigarette tax, and closing the loopholes in our smokefree laws. All of these measures stand to save the lives of New Hampshire residents.”

New Hampshire’s Grades 
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 2023 report, New Hampshire received the following grades: 
  1. Funding for State Tobacco Prevention Programs – Grade F
  2. Strength of Smokefree Workplace Laws – Grade D
  3. Level of State Tobacco Taxes – Grade F
  4. Coverage and Access to Services to Quit Tobacco – Grade D
  5. Ending the Sale of All Flavored Tobacco Products – Grade F 
This year’s report noted the need for New Hampshire policymakers to focus on increasing funding for tobacco prevention and quit smoking programs. An investment in prevention is especially important given the ongoing youth vaping epidemic. Despite receiving nearly $275 million from tobacco settlement payments and tobacco taxes, New Hampshire only funds tobacco control efforts at less than 10% of the level recommended by the Centers for Disease Control and Prevention (CDC). The Lung Association believes the funds should be used to support the health of our communities, and to prevent tobacco use and help people quit, and not switch to e-cigarettes. These programs are also critical for helping to end tobacco-related health disparities. 

In addition to advocating for funding for tobacco prevention programs, another top priority for the Lung Association in 2023 will be the reauthorization of the New Hampshire Medicaid expansion program–Granite Advantage—to ensure continued access to healthcare and tobacco treatment and cessation for New Hampshire residents enrolled in the program.

Finally, it is critical that New Hampshire increase tobacco taxes and close loopholes in its smokefree laws.  In the last legislative session, measures were introduced to weaken both of these policies which are proven effective in reducing tobacco use and exposure. Multiple studies have shown that every 10% increase in the price of cigarettes reduces consumption by about 4% among adults and about 7% among youth. New Hampshire’s tobacco tax rate remains the lowest in the northeast and lawmakers should increase its tax by at least $1.50 per pack. Similarly, passing a comprehensive smokefree law that eliminates smoking in all public places and workplaces, including restaurants, bars and casinos, would protect workers across the state from deadly secondhand smoke. E-cigarettes must also be included in comprehensive smokefree laws, given the harmful emissions that come from them.

Federal Grades Overview
The report also grades the federal government on their efforts to eliminate tobacco use. This year, there were new steps taken by the government to prevent and reduce tobacco use, including proposed rules to end the sale of menthol cigarettes and flavored cigars, Congress passing a law requiring the FDA to regulate tobacco products made with synthetic nicotine, and increased federal enforcement of the Tobacco Control Act. As a result of these steps forward, the federal government’s grade for “Federal Regulation of Tobacco Products” improved from a “D” grade last year, to a “C” grade in the 2023 report.

The 2023 “State of Tobacco Control” report grades the federal government in five areas: 
  • Federal Government Regulation of Tobacco Products – Grade C
  • 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 A
  • Federal Minimum Age of Sale for Tobacco Products to 21 – Incomplete
FDA is overdue in publishing the final Tobacco 21 regulations as required by statute, which is why it earns an “incomplete.”  

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

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