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The American Lung Association has identified five key actions for the Biden administration and Congress to take in 2024 that will help ultimately eliminate the death and disease caused by tobacco use:

  1. The White House must swiftly finalize the two rules that will remove all menthol cigarettes and flavored cigars from the marketplace;
  2. The Food and Drug Administration (FDA) must finalize its review of all premarket tobacco product applications for both tobacco-derived and synthetic-nicotine products; 
  3. The FDA and the Departments of Justice and Homeland Security must act to remove all illegal tobacco products from the marketplace;
  4. Congress must at least maintain current funding for the Centers for Disease Control and Prevention (CDC)’s Office on Smoking and Health;
  5. Congress must pass H.R. 4775, the Helping Tobacco Users Quit Act, bipartisan legislation giving more people access to the resources they need to quit tobacco.

In addition, FDA is overdue in finalizing the Tobacco 21 regulations as required by statute, which is why they earn an “incomplete” for the fifth and final grade on Federal Minimum Age of Sale for Tobacco Products. Congress ordered FDA to finalize these rules in 2020.  

Key highlights from 2024 include:

  • In February, President Biden announced his unity agenda, of which the Cancer Moonshot was prominently featured, announcing a goal to cut U.S. cancer death rates in half in 25 years. In it, the President specifically called out smoking as the greatest cause of deaths from cancer in the U.S. In June, the White House hosted the first ever forum on tobacco cessation.
  • In January and October, FDA rejected premarket applications from Reynolds Tobacco for flavored e-cigarettes, including for its popular Vuse Alto menthol e-cigarettes; Reynolds has subsequently filed a lawsuit against FDA in the US Court of Appeals for the Fifth Circuit, challenging that decision. The Lung Association and our partners filed an amicus brief in that case, one of 6 amicus briefs in similar cases challenging FDA e-cigarette marketing denial orders that were filed in 2023. 
  • Some in the House of Representatives actively worked to undermine federal efforts to reduce tobacco use. In May, the House Committee on Appropriations added a legislative provision called a rider to the FDA’s funding bill that would prohibit FDA from finalizing the menthol cigarette rules. In July, the House Appropriations Committee’s funding bill proposed to entirely eliminate the CDC’s Office on Smoking and Health.
  • In May, FDA took enforcement action against retailers that were selling illegal e-cigarettes. In December, U.S. Customs and Border Protection working with FDA seized illegal e-cigarettes that were being smuggled into the U.S., including Elf Bar, the most popular brand among youth.
  • In July, court-ordered signs warning of health risks caused by smoking were posted by the major U.S. tobacco companies in about 200,000 retail outlets across the nation that sell cigarettes, telling the public the truth about the deadly consequences of cigarette smoking. This was a remedy in the Department of Justice’s civil racketeering lawsuit against major tobacco companies.
  • In October, the draft rules that would end the sale of menthol cigarettes and flavored cigars were transmitted to the White House for a final review. While a late December release was expected, in December, the White House announced a delay until at least March 2024 after it met with officials representing the tobacco companies. The Cancer Moonshot 25-year target cannot be achieved until and unless the two rules are implemented.

The Lung Association is carefully watching two different threats to important tobacco control efforts: the first, Braidwood v. Becerra, a lawsuit that could result in the elimination of the Affordable Care Act requirement that tobacco cessation coverage be provided to most people without cost-sharing. The Lung Association has weighed in via amicus brief opposing the removal of this critical provision. The second is a lawsuit brought by R.J. Reynolds in the Fifth Circuit Court of Appeals that continues to hold up the graphic warning labels for cigarette packs.

Federal Facts
Healthcare Costs Due to Smoking: $600,000,000,000
Adult Smoking Rate: 11.6%
Adult Tobacco Use Rate: 19.3%
High School Smoking Rate: 1.9%
High School Tobacco Use Rate: 12.6%
Middle School Smoking Rate: 1.1%
Middle School Tobacco Use Rate: 6.6%
Smoking Attributable Deaths per Year: 480,320
Smoking Attributable Lung Cancer Deaths Per Year: 163,700
Smoking Attributable Respiratory Disease Deaths per Year: 113,100

Adult smoking and tobacco use rates are taken from the 2022 National Health Interview Survey. High school and middle school smoking and tobacco use rates are taken from the 2023 National Youth Tobacco Survey.

Economic cost information is for 2018 and from multiple sources, see this CDC website page for details. Smoking attributable deaths reflect average annual estimates for the period 2005-2009 and are calculated for persons aged 35 years and older. Smoking-attributable health care expenditures are based on 2004 smoking-attributable fractions and 2009 personal health care expenditure data. Deaths and expenditures should not be compared by state. 

Federal Information

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

Federal Grades Report Methodology