How does your state compare?

Tobacco use remains the leading cause of preventable death and disease in the United States and in North Dakota. To address this enormous toll, the American Lung Association calls for the following actions to be taken by North Dakota's elected officials:

  1. Raise the state tobacco tax currently at $0.44 per pack;
  2. Preserve funding for commercial tobacco prevention and control programs; and
  3. Restrict access to all flavored commercial tobacco products.
North Dakota ranks among the lowest in the U. S. for its cigarette tax of 44 cents per pack, compared to a national average of $2.05. The tax has not been raised in over 30 years.

This year's legislative session in North Dakota two bills were introduced to raise the tax.

The American Lung Association joined “Stand Up for Youth – ND” partners in a bi-partisan effort (House Bill 1570) to increase the tax on cigarettes by $1.00 per pack, bringing the total cigarette tax to $1.53. The bill would have increased the tax on other commercial tobacco products and implemented a tax on e-cigarettes and nicotine pouches. These products fuel North Dakota's youth nicotine addiction problem with some of the highest rates of youth e-cigarette use in the country.

The other proposal (Senate Bill 2281) was a modest $0.25 cent increase. While the Lung Association supports increasing the tax on all commercial tobacco products, concerns were expressed about the amount proposed as being too low to generate the impact needed for public health impacts. The bill passed out of committee and ultimately the Senate but failed in the House. Tobacco industry activities in North Dakota were in full force in opposing any increase in tobacco taxes. Ultimately, both bills were aggressively lobbied against by the tobacco industry and both failed to pass.

A bill (House Bill 1440) that weakens the North Dakota Clean Indoor Air Act also passed amending the current cigar lounge loophole to allow pipe smoking.

On a positive note, the budget appropriations for North Dakota's tobacco prevention and control program were approved and funding to establish an e-cigarette registry was removed from the proposed Attorney General's budget.

The American Lung Association will continue to work together with "Stand Up for Youth – ND” a growing coalition of community, state and national organizations working to increase the price of all commercial tobacco products in North Dakota to protect youth, reduce smoking rates, lower healthcare costs and save lives.

North Dakota Facts
Healthcare Costs Due to Smoking: $325,798,988
Adult Smoking Rate: 13.30%
Adult Tobacco Use Rate: 23.80%
High School Smoking Rate: 5.40%
High School Tobacco Use Rate: 19.60%
Middle School Smoking Rate: N/A
Smoking Attributable Deaths per Year: 980
Adult smoking and tobacco use data come from CDC's 2023 Behavioral Risk Factor Surveillance System; adult tobacco use includes cigarettes, smokeless tobacco and e-cigarettes. High school smoking and tobacco use rates are taken from CDC's 2023 Youth Risk Behavior Surveillance System. A current middle school smoking rate is not available for this state.

Health impact information is taken from the Smoking-Attributable Mortality, Morbidity and Economic Costs (SAMMEC) software. Smoking-attributable deaths reflect average annual estimates for the period 2005-2009 and are calculated for persons aged 35 years and older. Smoking-attributable healthcare expenditures are based on 2004 smoking-attributable fractions and 2009 personal healthcare expenditure data. Deaths and expenditures should not be compared by state.

North Dakota Information

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

State Grades Report Laws & Policies Historical Data