Tobacco use in Alabama 2021

• In 2020, 18.5% of adults smoked. Nationally, the rate was 15.5%.¹
• In 2019, 7.1% of high school students in Alabama smoked cigarettes on at least one day in the past 30 days. Nationally, the rate was 6.0%.²

• In 2017, 4.9% of adults in Alabama used e-cigarettes.³
• In 2020, 5.7% of adults in Alabama used smokeless tobacco.³
• In 2019, 19.4% of high school students in Alabama used electronic vapor products on at least one day in the past 30 days. Nationally, the rate was 32.7%.²
• In 2019, 8.9% of high school students in Alabama used chewing tobacco, snuff or dip on at least one day in the past 30 days. Nationally, the rate was 3.8%.²
• In 2019, 9.5% of high school students in Alabama smoked cigars, cigarillos or little cigars on at least one day in the past 30 days. Nationally, the rate was 5.7%.²

• Alabama received $289.6 million (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2021.⁴
• Of this, the state allocated $1.5 million in state funds to tobacco prevention in fiscal year 2021, just 2.7% of the Centers for Disease Control and Prevention’s annual spending target.⁴
• Smoking-related health care costs: $1.88 billion per year.⁴
• Smoking-related losses in productivity: $2.71 billion per year.⁵

Tobacco taxes

• Alabama is ranked 41st in the U.S. for its cigarette tax of 67.5 cents per pack (enacted October 2015), compared with the national average of $1.91. (The District of Columbia has the highest tax at $4.50 and Missouri has the lowest at 17 cents.) ^6-8
• Chewing tobacco is taxed at 1.5 cents per ounce. All other tobacco products have varying taxes based on weight and price.^6,7

Clean indoor air ordinances

• Smoking is restricted in all government workplaces, schools, childcare facilities, retail stores and recreational/cultural facilities.⁷
• Smoking restrictions are not required in private workplaces, restaurants, bars or casinos/gaming establishments.⁷
• The use of e-cigarettes is prohibited at licensed day care facilities and licensed emergency medical providers cannot use e-cigarettes while operating or riding in an ambulance or while providing patient care.⁹

Licensing laws

• Retailers and wholesalers are required to obtain a license to sell tobacco products.⁶
• A retail license is required to sell e-cigarette products. A county may not issue a license for sales of e-cigarettes if the retail business is located within 1,000 feet of a school, child-care facility, church, public library, playground or park, or other youth-centered facility or space after January 1, 2020 (unless the retailer is a specialty shop that has been in business at that location for 18 consecutive months).⁹

Youth access laws

• Effective December 2019, the United States adopted a law raising the federal minimum age of sale of all tobacco products to 21.  Some states have not yet raised their state minimum age of sale, however, the federal law takes precedence.
• Establishments are required to post signs stating that sales to underage consumers are prohibited.⁶
• Underage persons are prohibited from buying, using, and possessing tobacco products or tobacco-derived products, as well as electronic nicotine delivery systems.⁹
• The sale or distribution of electronic nicotine delivery systems, which include e-cigarettes, to underage persons is prohibited.
• Underage employees may handle electronic nicotine delivery systems when an employee over age 21 is present.⁹
• Self-service displays of electronic nicotine delivery systems are restricted to tobacco specialty stores or vending machine sales in areas inaccessible to persons under age 21 years or is under the direct control of an employee.⁹
• Delivery sales of electronic nicotine delivery systems may only be made after obtaining a permit for delivery sales and verifying the age and address of the purchaser through a third-party verification service, and taking payment through a credit or debit card in purchaser’s name.⁹
• Advertising electronic nicotine delivery systems on a billboard as available in flavors other than tobacco, mint or menthol or within 1,000 feet of any school or public playground is prohibited.⁹
• Specialty retailers or manufacturers of electronic nicotine delivery systems may not use the brand names of such products to sponsor scholarships, events for which individuals aged 21 years or older make up less than 85 percent of performing participants, nor advertise in print or digital publications for which individuals aged 21 years or older make up less than 85 percent of the readership.⁹
• Electronic nicotine delivery systems may not be advertised or marketed using terms like “candy” or other sweet or dessert-like descriptors, or any other imagery that is known to appeal to minors.⁹

• The CDC estimates 54.1% of daily adult smokers in Alabama quit smoking for one or more days in 2019.³
• In 2014, the Affordable Care Act required that Medicaid programs cover all quit medications.^7**
• Alabama’s state quit line invests $1.05 per smoker, compared with the national average of $2.28.⁷
• Alabama does not have a private insurance mandate provision for quitting tobacco.⁷

Updated August 2021

*National and state-level prevalence numbers reflect the most recent data available. This may differ across state fact sheets.

**The seven recommended quitting medications are NRT gum, NRT patch, NRT nasal spray, NRT inhaler, NRT lozenge, Varenicline (Chantix) and Bupropion (Zyban).

Fiore MC, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: US Department of Health and Human Services. Public Health Service: May 2008.

1. CDC, Behavioral Risk Factor Surveillance System, 2020.

2. CDC, Youth Risk Behavioral Surveillance System, 2019.

3. CDC, Behavioral Risk Factor Surveillance System, State Tobacco Activities Tracking and Evaluation System, 2021.

4. Campaign for Tobacco-Free Kids, Broken Promises to Our Children: a State-by-State Look at the 1998 State Tobacco Settlement 22 Years Later FY2021, 2020.

5. Campaign for Tobacco-Free Kids, Toll of Tobacco in the United States.

6. American Lung Association, State Legislated Actions on Tobacco Issues (SLATI).

7. American Lung Association, State of Tobacco Control, 2021.

8. Campaign for Tobacco-Free Kids. State Cigarette Excise Tax Rates & Rankings. https://www.tobaccofreekids.org/assets/factsheets/0097.pdf. Accessed.

9. Public Health Law Center. U.S. E-Cigarette Regulation: 50-State Review. http://www.publichealthlawcenter.org/resources/us-e-cigarette-regulations-50-state-review. Accessed.