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

  1. Increase funding for tobacco prevention and control programs;
  2. Eliminate the e-cigarette tax loophole with a tax at parity with cigarettes; and
  3. Improve the state’s surveillance of tobacco retailers, ensuring each retailer is subject to an annual compliance check.
While the Texas Legislature did not convene in 2022, the impact of their actions in 2021 began to take shape. Starting January 1, 2022, e-cigarette retailers are required to hold a permit to sell their products. As of August 2022, more than 12,000 e-cigarette retailers have submitted and received permits. The state now has a more comprehensive database of tobacco and e-cigarette retailers, which can be a critical tool for both enforcement of tobacco sales laws and community monitoring of retailers.

Despite the improvements around tobacco and e-cigarette retail licensure, the state significantly cut funding for tobacco enforcement programs, leading to thousands fewer controlled buys on tobacco retailers. Efforts are underway to improve the retailer compliance structure to ensure every tobacco retailer is subject to a compliance check.

The American Lung Association and partners spent 2022 advocating for increased funding for the state’s tobacco control programs, meeting with agency staff and advocating at several public meetings. In late 2022, the Department of State Health Services revealed their proposed budget through the Legislative Appropriations Request. For the first time in several sessions, the request included an increase in tobacco control funds of approximately $3 million annually. The decision on whether to approve these funds now rests with the legislature.

In addition to the state’s spending through the Department of State Health Services, the Cancer Prevention and Research Institute of Texas continued to make investments in tobacco prevention. In 2022, more than $5 million in grants went to researchers and programs focused on tobacco prevention and cessation. Since 2009, more than $22 million has been granted to support tobacco prevention efforts through the cancer fighting state agency.

Texas lawmakers have a unique opportunity to take bold action on tobacco in the 2023 legislative session. With an estimated budget surplus of $27 billion, the state must invest more in tobacco prevention and cessation programs. Its current funding ranks Texas near the bottom nationally of per-capita spending on tobacco control and is the key foundation upon which other tobacco prevention and reduction policies are built. Secondly, after two sessions of action on e-cigarette taxes, we urge the legislature to finally pass a robust tax on e-cigarettes, as a percentage of price, and dedicate those funds to tobacco control programs.

Texas Facts
Healthcare Costs Due to Smoking: $8,855,602,443
Adult Smoking Rate: 13.10%
High School Smoking Rate: 3.90%
High School Tobacco Use Rate: 19.10%
Middle School Smoking Rate: 1.80%
Smoking Attributable Deaths per Year: 28,030
Adult smoking data come from CDC's 2021 Behavioral Risk Factor Surveillance System. High school (11th grade only) smoking and tobacco use and middle school (8th grade only) smoking rates are taken from the 2020 Texas School Survey.

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.

Texas Information

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

State Grades Report Laws & Policies