The American Lung Association’s 2024 “State of Tobacco Control” report, released today, highlights “the failure of the Biden administration” to finalize rules to end the sale of menthol cigarettes and flavored cigars in 2023.

The 22nd annual report evaluates state and federal efforts to eliminate tobacco use with tobacco control laws and policies and assigns letter grades, A through F, to the state and federal policies best proven to prevent and reduce tobacco use.

“Menthol cigarettes make it both easier to start and harder to quit by reducing the harshness of the smoke and cooling the throat. Once these rules are final, fewer people will start smoking, millions will begin their journey to quit, and lives will be saved,” says Harold Wimmer, president and CEO of the American Lung Association, in a release. “We know that the tobacco industry will do anything to protect their profits at the expense of public health, so the White House must focus on implementing lifesaving policies and push back against the industry’s delay tactics.”

Federal Grades Overview

The federal section of the report draws attention to the unfinished regulations by the Biden administration regarding the ban of menthol cigarettes and flavored cigars sales, initially expected in December 2023. It also notes the ongoing delay by the US Food and Drug Administration (FDA) in finalizing its review of pre-market tobacco product applications, along with the beginning of enforcement actions against unauthorized e-cigarette products.

In the “State of Tobacco Control” report, the lung association identified four key actions for the Biden administration and Congress to take in 2024: 

  1. The White House must finalize the rules to end the sale of menthol cigarettes and flavored cigars; 
  2. FDA must finalize premarket review and work with other federal agencies to remove all illegal e-cigarettes and other flavored products from the marketplace;
  3. Congress must maintain or increase current funding for the Centers for Disease Control and Prevention (CDC)’s Office on Smoking and Health; and
  4. Congress must pass HR 4775, the Helping Tobacco Users Quit Act, bipartisan legislation giving more people access to the resources they need to quit tobacco.

The 2024 “State of Tobacco Control” report grades the federal government in five areas:

  • Federal Regulation of Tobacco Products – Grade C
  • Federal Coverage of Quit Smoking Treatments – Grade D
  • Level of Federal Tobacco Taxes – Grade F
  • Federal Mass Media Campaigns to Prevent and Reduce Tobacco Use – Grade: A
  • Federal Minimum Age of Sale for Tobacco Products to 21 – Incomplete*

*FDA is overdue in finalizing the Tobacco 21 regulations as required by statute 

State Grades Overview

The 2024 “State of Tobacco Control” report grades states and the District of Columbia in five areas that have been proven to prevent and reduce tobacco use and save lives:

  • Strength of Smokefree Workplace Laws – 16 states and Washington DC earned “A” grades
  • Ending the Sale of All Flavored Tobacco Products – 45 states earned “F” grades
  • Funding for State Tobacco Prevention Programs – 41 states and Washington DC earned “F” grades
  • Level of State Tobacco Taxes – 31 states earned “F” grades
  • Coverage and Access to Services to Quit Tobacco – 20 states and Washington DC earned “A” or “B grades

Best Graded States

  • California: Tobacco Program Funding: C, Smokefree Air: A, Tobacco Taxes: C, Access to Cessation: A, Flavored Tobacco Products: B
  • District of Columbia: Tobacco Program Funding: F, Smokefree Air: A, Tobacco Taxes: A, Access to Cessation: B, Flavored Tobacco Products: A
  • Massachusetts: Tobacco Program Funding: F, Smokefree Air: A, Tobacco Taxes: B, Access to Cessation: B, Flavored Tobacco Products: A

Worst Graded States

  • Alabama and Georgia rated the worst in the nation, scoring Fs in all five categories
  • Mississippi, North Carolina, Tennessee, Texas, and West Virginia received 4 Fs and 1 D grade

“The report finds that federal, state, and local governments need to do more to stand up against the tobacco industry and reduce tobacco use, especially among youth. We cannot afford to lose another generation to tobacco-caused addiction, disease, and death,” according to a release from the American Lung Association. 

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