State of Tobacco Control 2022 Report

The American Lung Association (ALA) has released its 20th annual State of Tobacco Control report. The 2022 State of Tobacco Control report reflects on the collective progress in reducing tobacco use at the state and federal level in the last 20 years, discusses proven policies that reduce tobacco use and uses a grading system to assess the current state of tobacco control in all 50 states, the District of Columbia and at the federal level to highlight the further work to be done.

The report acts as a road map to tobacco control and prevention policies for state and federal governments to implement. It also reflects on “20 years of uneven change in State Tobacco Prevention Policies,” which highlights the fact that success in tobacco prevention and control policies has varied by decade, geographic region and policy.

One of the main focal points of the 2022 report is health disparities related to tobacco use. The overall adult smoking rate disguises tobacco-related disparities among different racial and ethnic populations, in LGTBQ+ communities and disparities due to socio-economic factors. While the overall smoking rate decreased significantly from 2003 – 2019, adult smoking rates in different populations remain almost as high as the overall rate was in 2003. In addition to higher adult and youth smoking rates in certain populations compared to overall rates, certain communities are exposed at a higher rate to secondhand smoke and use menthol cigarettes at a higher rate.

The 2022 report includes:

Key Findings

    • In the last 20 years, the number of smokefree states has increased from 2 to 28.
    • The adult cigarette smoking rate has decreased from 21.6% to 14% over 16 years. However, commercial tobacco use is still higher in certain populations. For example, in 2019 the cigarette smoking rate in LGBTQ+ communities was at 19.2%.
    • While the COVID-19 pandemic’s impact on commercial tobacco use is still being evaluated, a report published in 2020 by the Federal Trade Commission stated that 2020 was the first time in 20 years that cigarette sales increased.
    • The average state cigarette tax has increased $1.29 since January 2003. However, from state to state there is a wide range of cigarette tax rates with the lowest at 17 cents and the highest at $4.50.

State Grades

The bullet points below list the number of states who received a B or higher for each category the states were graded in. The states were graded on five components. State grading charts include all 50 states and the District of Columbia.

    • Tobacco prevention and cessation funding: Four states received a B or higher
    • Smokefree air policies: 30 states received a B or higher
    • Tobacco taxes: Eight states received a B or higher
    • Access to cessation services: 19 states received a B or higher
    • Flavored tobacco product laws: One state received a B or higher

Federal Grades

The federal government was graded on five components:

    • Regulation of tobacco products
    • Mass media campaigns
    • Minimum age (tobacco 21)
    • Tobacco taxes
    • Coverage for cessation treatment

Mass media campaigns were the only component the federal government received a B or higher in. Minimum age is marked as incomplete.

The 2022 State of Tobacco Control website is in an interactive platform that provides detail on the key findings, state grades and federal grades. States can easily view their grades, how they compare to other states and the ALA offers suggestions for policies of focus for each state.