(TNND) — The American Lung Association released its annual “State of Tobacco Control” report, sounding a warning that cuts to federal anti-smoking programs might endanger efforts to curb use.
Tobacco use is the leading preventable cause of disease, disability and death in the U.S., according to the Centers for Disease Control and Prevention.
But the Lung Association said the CDC’s Office on Smoking and Health has been virtually eliminated as part of broader cuts to the Department of Health and Human Services.
Thomas Carr, the Lung Association’s director of national policy, said federal tobacco prevention efforts have gotten worse in the last year.
“We’ve seen some pretty fundamental change,” Carr said.
The “Tips from Former Smokers” campaign that was operated out of that CDC office is off the air for now, he said.
The Food and Drug Administration, which regulates tobacco products, also saw significant staff cuts, he said.
And federal funding that helps states offer smoking cessation programs was delayed last year.
Youth tobacco use is at a 25-year low, and adult smoking rates have dropped to about 10% from close to 25% in 2000.
The Lung Association said sustained efforts to reduce tobacco use work, but Carr said the progress is in jeopardy, especially if the CDC’s Office on Smoking and Health remains effectively closed.
The Lung Association’s 2026 “State of Tobacco Control” report dropped the federal grade for regulating tobacco products from a “C” to a “D,” and the grade for the federal government’s anti-smoking mass media campaigns went from an “A” in 2025 to an incomplete this year.
Carr said some states are stepping up to the plate a little more, but efforts vary widely across the country.
Efforts even vary widely within states, where they excel in some areas and struggle in others.
“I think Oklahoma is a good example,” Carr said. “They get an ‘A’ in tobacco prevention control program funding, but they have some … worse grades in some other areas, like tobacco taxes and smoke-free air.”
The Lung Association graded states in five areas: strength of smoke-free workplace laws, efforts to restrict the sale of all flavored tobacco products, funding for state tobacco prevention programs, level of state tobacco taxes, and coverage and access to services to quit tobacco.
The best-graded states included California, Colorado, Delaware, Maine and Massachusetts, along with the District of Columbia.
The worst-graded states were Alabama, Georgia, Mississippi and Texas.
Maine and Montana were highlighted as the most-improved states.
American Lung Association, file
Maine, for example, boosted its grade for tobacco taxes from a “C” to a “B” and its grade for smoke-free air from a “B” to an “A.” Maine increased its cigarette tax by $1.50 to $3.50 per pack and fully added e-cigarettes to its smokefree workplace law.
Over 40 states earned “F” grades for their lack of effort to stop the sale of flavored tobacco products.
Forty states earned failing grades for their levels of tobacco prevention program funding.
Carr said the Lung Association found big differences across the country in smoke-free air laws, where over a dozen states earned “A” grades and a dozen others failed that area.
Carr said the Lung Association wants to see the federal government restore the CDC’s Office on Smoking and Health.
He said the Lung Association wants to see states with low tobacco taxes increase those.
And Carr said the Lung Association wants to see states beef up their smoke-free laws if needed.
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