Fact Sheet

Tobacco use: Missouri 2026

Topic

Smoking by Region

Subtopic

State Facts

Cigarette use: Missouri*

In 2024, 14.7% of adults in Missouri smoked. Nationally, the adult cigarette smoking prevalence was 11.6%.
In 2018-2019, 33.9% of adults who smoked in Missouri smoked menthol cigarettes. Nationally, 32.3% of adult smokers used menthol cigarettes during this period.
In 2023, 6.2% of high school students in Missouri smoked cigarettes on at least one day in the past 30 days. Nationally, the cigarette smoking prevalence among high school students was 3.5%.

Other tobacco product use: Missouri*

In 2024, 8.2% of adults in Missouri used e-cigarettes. Nationally, the adult e-cigarette use prevalence was 8.0%.
In 2024, 4.7% of adults in Missouri used smokeless tobacco every day or some days. Nationally, the adult smokeless tobacco use prevalence was 3.4%.
In 2023, 21.3% of high school students in Missouri used electronic vapor products on at least one day in the past 30 days. Nationally, the e-cigarette use prevalence among high school students was 16.8%.
In 2023, 2.8% of high school students in Missouri used chewing tobacco, snuff or dip on at least one day in the past 30 days. Nationally, the smokeless tobacco use prevalence among high school students was 2.3%.
In 2023, 4.9% of high school students in Missouri smoked cigars, cigarillos or little cigars on at least one day in the past 30 days. Nationally, the cigar use prevalence among high school students was 4.5%.

Economics of tobacco use and tobacco control

Missouri received $217.9 million (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2026.
Of this, the state allocated $5.4 million in state funds to tobacco prevention in fiscal year 2026, 7.4% of the Centers for Disease Control and Prevention's annual spending target.
Smoking-caused health care costs: $3.52 billion per year.
Smoking-caused losses in productivity: $7.1 billion per year.

Missouri tobacco laws

Tobacco taxes

Missouri is ranked 51st in the U.S. for its cigarette tax of 17 cents per pack (enacted August 1993) compared to the national average of $2.05. (New York has the highest tax at $5.35).
All other tobacco products are taxed at 10% of the manufacturer's invoice price.

Clean indoor air ordinances

Smoking is prohibited in schools (public schools only) and childcare facilities.
Smoking restrictions are required in government workplaces, private workplaces, restaurants, and retail stores.
There are no smoking restrictions for bars and casinos/gaming establishments.
Vaping is restricted to designated areas of public buildings and grounds occupied by state agencies and is prohibited in public school buildings or buses. E-cigarette use is prohibited in foster homes, vehicles transporting foster children, and in the presence of foster children.
E-cigarettes are not included in the state's indoor air laws or the state's definition of tobacco products.

Licensing laws

Wholesalers are required to obtain a license to sell tobacco products. Retailers are not required to obtain a license to sell tobacco products.
A license is required to sell e-cigarette products.

Youth access laws

In December 2019, the United States adopted a law raising the federal minimum age of sale of all tobacco products to 21, effective immediately.
People under 21 are prohibited from buying nicotine delivery products, including e-cigarettes.
Establishments are required to post signs stating that sales to minors are prohibited.
Vending machine sales are restricted to places inaccessible to people under age 18 or through machines equipped with a lock-out device and under direct unobstructed supervision of an adult.

Local tobacco laws

St. Louis prohibits the use of smokeless tobacco products at all sports venues, including Busch Stadium.

Quitting statistics and benefits

The CDC estimates 44.4% of daily adult smokers in Missouri quit smoking for one or more days in 2019.
In 2014, the Affordable Care Act required that Medicaid programs cover all tobacco cessation medications.**
Missouri's state quit line invests $1.04 cents per smoker, compared to the national median of $2.62.
Missouri does not have a private insurance mandate provision for cessation.

Notes and references

Updated March 2026

*The datasets for both adults and youth prevalence were used to make direct comparisons at the state and national levels. National prevalence reported here may differ from what is reported in our national-level fact sheets. The numbers here also reflect the most recent data available. Dates of available data may differ across state fact sheets.

**The seven recommended cessation 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.

CDC. (2024). Behavioral Risk Factor Surveillance System.
CDC. (2024). State Menthol Fact Sheets.
CDC. (2023). High School Youth Risk Behavioral Surveillance System.
Campaign for Tobacco-Free Kids. (2026). Broken Promises to Our Children: A State-by-State Look at the 1998 Tobacco Settlement 27 Years Later. Campaign for Tobacco-Free Kids. https://www.tobaccofreekids.org/what-we-do/us/statereport
Campaign for Tobacco-Free Kids. (2024). The Toll of Tobacco in the United States. Campaign for Tobacco-Free Kids.
American Lung Association. (2024). State Legislated Actions on Tobacco Issues (SLATI).
American Lung Association. (2026). State of Tobacco Control. https://www.lung.org/research/sotc
Campaign for Tobacco-Free Kids. (2024). State Cigarette Excise Tax Rates & Rankings. https://assets.tobaccofreekids.org/factsheets/0097.pdf
Public Health Law Center. (2024, June 15). U.S. E-Cigarette Regulations: 50 State Review. https://www.publichealthlawcenter.org/resources/us-e-cigarette-regulations-50-state-review
FDA. (2024). Tobacco 21. https://www.fda.gov/tobacco-products/retail-sales-tobacco-products/tobacco-21
Knock Tobacco Out of the Park. (2024). https://tobaccofreebaseball.org/
CDC. (2024). Behavioral Risk Factor Surveillance System, State Tobacco Activities Tracking and Evaluation System.