Public health organizations are urging the United States to raise tobacco taxes

A new report published by the Campaign for Tobacco Free-Kids, the American Heart Association, the American Cancer Society, the American Lung Association, Americans for Nonsmokers' Rights, and the Truth Initiative recommends that U.S. states significantly increase tobacco taxes.[1]. According to its authors, this measure would both reduce tobacco consumption and generate additional revenue to fund essential prevention and public health programs. However, the main obstacle to this fundamental tobacco control measure, as with other measures, remains industry interference in a country with highly unequal decentralized health policies and a central government hostile to the WHO and its recommendations.

Smoking prevention and cessation programs are largely underfunded despite the health emergency.

The publication of this report comes as states prepare their 2026 budgets, amidst deficits exacerbated by recent cuts to federal healthcare funding. Medicaid and the Centers for Disease Control and Prevention (CDC) have been particularly hard hit, with the latter's Office of Tobacco Control and Health being eliminated. This office played a crucial role in national efforts to reduce tobacco use and provided essential financial and technical support to each state.

The report highlights that smoking prevention and cessation programs remain severely underfunded. For fiscal year 2026, states will allocate $728.6 million (€620 million) to these programs, a decrease of $36.2 million (€30 million) compared to 2025 and only $22 billion of the $3.3 billion (€2.8 billion) recommended by the CDC.

Only Maine meets the CDC's recommended 100 million dollars in funding, while eight other states provide at least 50 million dollars of the recommended funding levels. Seventeen states allocate less than 10 million dollars of the recommended amounts, including eight states that spend less than 5 million dollars of the recommended funding levels. New Hampshire, for its part, allocates no public funds to smoking prevention programs.[2].

As an indication, the tobacco industry's reported national marketing expenditures — more than $8.6 billion (€7.3 billion) per year — are almost twelve times greater than public budgets allocated to prevention.

Yet smoking remains the leading cause of preventable death in the United States, with nearly 500,000 deaths annually and more than $241 billion (€205 billion) in health costs, of which more than 60% are funded by taxpayers through government programs like Medicare and Medicaid.

Despite a continued decline, approximately 26 million adults still smoke, representing nearly 10% of American adults, and more than 2.25 million young people use tobacco or other nicotine products, including more than 1.6 million vapers.

Furthermore, the nicotine epidemic is further fueled by the illegal distribution of numerous flavored and high-nicotine products, which contribute to early addiction among young people. Meanwhile, the industry continues to promote its products through promotional offers and discount coupons.

Significant health and financial gains thanks to a $1.50 increase per pack

The organizations that signed this report therefore call for a coordinated strengthening of tobacco taxation and the funding of prevention policies, in particular through the restoration by Congress of funding for the CDC's tobacco control program, in order to consolidate the progress made and limit the health, economic and social impact of smoking.

The report assesses the effects of an increase of $1.50 (€1.28) per pack of cigarettes if it were applied in all fifty states and in Washington, DC, which, as the federal capital, is not part of the states of the Union and depends directly on Congress.

Such a measure would collectively prevent 231,600 children from starting to smoke, encourage 860,300 adults to quit smoking in the first year and avoid 275,400 premature and preventable deaths related to tobacco.

From a financial perspective, this would also save $14.3 billion (€12.1 billion) in long-term health care spending, including $363 million (€309 million) for Medicaid over five years, and generate $6.1 billion (€5.2 billion) in new tax revenue in the first year.

National and WHO scientific data, for their part, reiterate that increasing tobacco taxes is the most effective strategy for reducing smoking, particularly among young people.[3] : at the national level in a high-income country, each 10 % increase in the real price of cigarettes reduces adult smoking by about 2 %, reduces young adult smoking by about 3.5 %, reduces the number of children who smoke by 6 to 7 % and reduces overall cigarette consumption by about 3 to 5 %.

Furthermore, this reduces the resulting non-communicable diseases such as cancers, heart disease, strokes, chronic obstructive pulmonary disease (COPD) and diabetes, thus helping to reduce long-term health expenditures.

The authors therefore emphasize the doubly beneficial nature of the measure, both in terms of health and income.

The interference of the tobacco and nicotine industry in public policy is the primary obstacle to essential reforms.

The WHO summarized it as follows:« Tobacco taxes are effective. That's why the industry invests so much money and effort in blocking significant tax increases and other effective fiscal reforms. ".

According to the 2025 edition of the Global Tobacco Industry Interference Index, which measures the degree of industry interference in public health policies, the country ranked particularly poorly. It is among countries like Japan, Georgia, Switzerland, and the Dominican Republic where the industry is extremely influential: tobacco companies still enjoy privileged access to policymakers and participate in the development of permissive and ineffective regulations. This influence also allows tobacco companies to improve their image and easily promote all their products.

The country has never had the WHO Framework Convention on Tobacco Control (FCTC) ratified by the Senate, and has recently withdrawn from it.[4]. The absence of the United States from the largest, and only, international public health treaty, which covers 90% of the world's population and combats the tobacco epidemic through numerous proven measures, such as tobacco taxes but also other non-fiscal measures like the affixing of health warnings on cigarette packs, raises even more questions about the presence of tobacco companies in American decision-making circles.

These same industrialists were also the biggest donors to Donald Trump's election campaign, campaigning to weaken or repeal anti-smoking bills, and are among the donors who contributed to the construction of the White House's multi-hundred-million-dollar ballroom. Trump's chief of staff has been accused of lobbying in favor of the tobacco industry, and several layoffs and reshuffling within the FDA and the CDC have raised concerns about serious conflicts of interest, as well as a possible relaxation of the rules for placing certain products on the market.

This permeability of the decision-making framework allows the industry to develop its risk reduction narrative, which is linked to its marketing strategy. It thus widely promotes its new products (e-cigarettes, heated tobacco, snus, nicotine pouches, etc.), particularly to teenagers and non-smokers, thereby... responsible for a worrying increase in these products among young people.

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[1]A State-by-State Look at the 1998 Tobacco Settlement 27 Years Later, Campaign for Tobacco-Free Kids, published January 21, 2026, accessed January 23, 2026

[2]FY2026 State Rankings: States Ranked by Percent of CDC-Recommended Funding Levels, Campaign for Tobacco-Free Kids, accessed January 23, 2026

[3]Raising cigarette taxes reduces smoking, especially among kids (and the cigarette companies know it), Campaign for Tobacco-Free Kids, published December 23, 2025, accessed January 23, 2026

[4]Imogen Foulkes, Ottilie Mitchell, US officially leaves World Health Organization, BBC, published on 23 January 2026, accessed the same day

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