Tobacco use in Iowa 2019

• In 2017, 17.1% of adults smoked. Nationally, the rate was 17.1%.¹
• In 2017, 9.9% of high school students in Iowa smoked cigarettes on at least one day in the past 30 days. Nationally, the rate was 8.8%.²

• In 2017, 4.0% of adults used e-cigarettes and 5.4% used smokeless tobacco.³
• In 2017, 9.0% of high school students in Iowa used electronic vapor products on at least one day in the past 30 days. Nationally, the rate was 13.2%.²
• In 2017, 6.2% of high school students in Iowa used chewing tobacco, snuff or dip on at least one day in the past 30 days. Nationally, the rate was 5.5%.²
• In 2017, 7.3% of high school students in Iowa smoked cigars, cigarillos or little cigars on at least one day in the past 30 days. Nationally, the rate was 8.0%.²

• Iowa received $274.2 million (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2019.⁴
• Of this, the state allocated $4 million in state funds to tobacco prevention in fiscal year 2019, 13.4% of the Centers for Disease Control and Prevention’s annual spending target.⁴
• Smoking-related health care costs: $1.28 billion per year⁴
• Smoking-related losses in productivity: $1.21 billion per year⁵

Tobacco taxes

• Iowa is ranked 30th in the U.S. for its cigarette tax of $1.36 per pack (enacted March 2007), compared with the national average of $1.81. (The District of Columbia has the highest tax at $4.50 and Missouri has the lowest at 17 cents.) ^6-8
• Little cigars are taxed at $1.36 per 20 cigars, snuff is taxed at $1.19 per ounce and all other tobacco products are taxed 50% of the manufacturer’s list price.^6,7

Clean indoor air ordinances

• Smoking is prohibited in all government workplaces, private workplaces, schools, childcare facilities, restaurants, bars, retail stores and recreational/cultural facilities.^6,7
• Smoking restrictions are required in casinos/gaming establishments (tribal establishments are exempt).^6,7
• The use of e-cigarettes is prohibited on state-owned buildings and grounds, on the campus of Iowa State University and the University of Iowa, and in foster homes and vehicles when a foster child is present.⁹

Youth access laws

• The minimum age to purchase tobacco products in Iowa is 21. In December 2019, the United States adopted a law raising the federal minimum age of sale of all tobacco products to 21, effective immediately.
• Minors are prohibited from buying alternative tobacco products, including e-cigarettes.^6,7

• The CDC estimates 45.5% of daily adult smokers in Iowa quit smoking for one or more days in 2017.³
• In 2014, the Affordable Care Act required Medicaid programs cover all quit medications.⁷**
• Iowa’s state quit line invests $1.84 per smoker, compared with the national average of $2.21.⁷
• Iowa does not have a private insurance mandate provision for quitting tobacco.⁷

Updated April 2019

*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, 2017.

2. CDC, Youth Risk Behavior Surveillance System, 2017.

3. CDC, Behavioral Risk Factor Surveillance System, State Tobacco Activities Tracking and Evaluation System, 2017.

4. Campaign for Tobacco-Free Kids, Broken Promises to Our Children: a State-by-State Look at the 1998 State Tobacco Settlement 20 Years Later FY2019, 2018.

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, 2019.

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

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.