Did your state make the grade?
Federal Regulation of Tobacco Products Cessation Coverage Tobacco Taxes Mass Media Campaigns Federal Minimum Age
D D F A I*
Federal Regulation of Tobacco Products D
Cessation Coverage D
Tobacco Taxes F
Mass Media Campaigns A
Federal Minimum Age I*

The American Lung Association has identified four key actions for the Biden Administration and Congress to take in 2022 that will help ultimately eliminate the death and disease caused by tobacco use:  

  1. FDA must adhere to the Tobacco Control Act and reject product marketing applications (PMTAs) for any product that fails to prove it is appropriate for the protection of the public health, including all flavored products; 
  2. The Biden Administration must propose and finalize rules that will remove all menthol cigarettes and flavored cigars from the marketplace;  
  3. Congress must increase federal funding for the Centers for Disease Control and Prevention (CDC)’s Office on Smoking and Health to help states combat the youth e-cigarette epidemic and to further strengthen its “Tips from Former Smokers” Campaign; and 
  4. The U.S. Department of Health and Human Services (HHS) must clarify and ensure that most health plans, including state Medicaid expansion plans, cover a comprehensive tobacco cessation benefit without barriers and cost-sharing: and Congress must pass the “Quit Because of COVID-19” Act.

Federal Information

Learn more about specific legislation regarding efforts toward effective Tobacco Control.

Highlights Methodology

Federal Information

Learn more about specific legislation regarding efforts towards effective Tobacco Control.

Highlights Methodology
Federal Regulation of Tobacco Products

Federal Regulation of Tobacco Products

Overall Grade D
Implementation of Rule Asserting Authority over All Tobacco Products: Rule partially implemented
Graphic Cigarette Warning Labels: Warning labels finalized, but not in effect*
Product Standards, including Flavored Tobacco Products: No product standard proposed or finalized
Funding for FDA Center for Tobacco Products: Operating on continuing resolution until February 2022

* FDA has finalized graphic warning labels for cigarettes, due to a federal court order the effective date for the rule is January 9. 2023. 

Help Fight Tobacco Use

Join our efforts to create a tobacco-free future. Stand with the American Lung Association to prevent and reduce tobacco use in your state.

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Cessation Coverage

Cessation Coverage

Overall Grade D
Medicaid Coverage: Partially Required
Medicare Coverage: Partially Covered
TRICARE Coverage: Covered
Federal Employee Health Benefits Coverage: Covered
State Health Insurance Exchanges: Partially Required

Help Fight Tobacco Use

Join our efforts to create a tobacco-free future. Stand with the American Lung Association to prevent and reduce tobacco use in your state.

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Thumbs Down

Thumbs down for the federal government for undermining healthcare access to comprehensive tobacco cessation coverage.

Tobacco Taxes

Tobacco Taxes

Overall Grade F
Cigarette Tax:
Tax rate per pack of 20: $1.01
Other Tobacco Product Taxes:
Little Cigars: Equalized: Yes; Weight-Based: Yes
Large Cigars: Equalized: No; Weight-Based: No
Smokeless Tobacco: Equalized: No; Weight-Based: Yes
Pipe/RYO Tobacco: Equalized: No; Weight-Based: Yes 
E-Cigarettes: Equalized: N/A; Weight-Based: N/A

Help Fight Tobacco Use

Join our efforts to create a tobacco-free future. Stand with the American Lung Association to prevent and reduce tobacco use in your state.

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Mass Media Campaigns

Mass Media Campaigns

Overall Grade A
Tips from Former Smokers Media Campaign:
Reach: Meets Target
Duration: Under Target
Frequency: Meets Target
Promotion of Services: Meets Target
FDA "Real Costs" Media Campaign:
Reach: Meets Target
Duration: Meets Target
Frequency: Meets Target
Promotion of Services: Under Target

Help Fight Tobacco Use

Join our efforts to create a tobacco-free future. Stand with the American Lung Association to prevent and reduce tobacco use in your state.

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Federal Minimum Age

Federal Minimum Age

Overall Grade I*
Minimum Age of Sale for Tobacco Products: 21

*The federal government gets an “I” for Incomplete because FDA has not issued implementing regulations that were required by statute to be issued by June 17, 2020.

Help Fight Tobacco Use

Join our efforts to create a tobacco-free future. Stand with the American Lung Association to prevent and reduce tobacco use in your state.

Take Action