Annual Tobacco Report Gives Federal Government Failing Marks, Warns Progress at Risk

The American Lung Association released its annual "State of Tobacco Control" report this week, grading government efforts to reduce tobacco use—and the results weren't great. While the nation has made significant strides over the past two decades, experts warn those gains are fragile.

Adult smoking rates have dropped from just over 23% in 2000 to below 11% in 2023, and youth tobacco use is at its lowest level in 25 years. But more than two million middle and high school students still use tobacco products, including e-cigarettes, and tobacco remains the leading cause of preventable death in the U.S., claiming more than 490,000 lives annually.

"Certainly not necessarily something you, a report card you'd want to bring home to your parents," said Thomas Carr, the report's chief author.

The federal government received a "D" for regulation of tobacco products and coverage of smoking cessation treatments, an "F" for federal tobacco tax levels, and an incomplete grade for mass media prevention campaigns. Funding for tobacco prevention and control earned a "B."

State grades were also a concern. No state received all A's. California, Colorado, Delaware, Washington D.C., Maine, and Massachusetts earned the highest marks, while Georgia, Mississippi, Texas, and Alabama received F's in all five grading categories.

The report warns that recent changes to tobacco prevention and cessation efforts could cause progress to "quickly unravel." What comes next for federal policy on tobacco regulation remains unclear.