Tobacco use in South Carolina 2021

• In 2020, 18.1% of adults smoked. Nationally, the rate was 15.5%.¹
• In 2019, 5.9% of high school students in South Carolina smoked cigarettes on at least one day in the past 30 days. Nationally, the rate was 6.0%.²

• In 2017, 4.1% of adults in South Carolina used e-cigarettes.³
• In 2020, 3.7% of adults in South Carolina used smokeless tobacco.³
• In 2019, 21.1% of high school students in South Carolina used electronic vapor products on at least one day in the past 30 days. Nationally, the rate was 32.7%.²
• In 2019, 7.1% of high school students in South Carolina 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, 9.1% of high school students in South Carolina smoked cigars, cigarillos or little cigars on at least one day in the past 30 days. Nationally, the rate was 5.7%.²

• South Carolina received $229.7 million (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2021.⁴
• Of this, the state allocated $5.0 million in state funds to tobacco prevention in fiscal year 2021, 9.8% of the Centers for Disease Control and Prevention’s annual spending target.⁴
• Smoking-caused health care costs: $1.90 billion per year.⁴
• Smoking-caused losses in productivity: $2.35 billion per year.⁵

Tobacco taxes

• South Carolina is ranked 46th in the U.S. for its cigarette tax of 57 cents per pack (enacted July 2010), compared to 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
• All other tobacco products are taxed at 5% of the manufacturer’s price.^6,7

Clean indoor air ordinances

• Smoking is prohibited in childcare facilities.^6,7
• Smoking restrictions are required in government workplaces, schools and recreational/cultural facilties.^6,7
• There are no smoking restrictions for private workplaces, restaurants, bars, casinos/gaming establishments and retail stores.^6,7
• The use of e-cigarettes is prohibited in ambulances.⁹
• All school districts must adopt, implement and enforce a written policy prohibiting the use of alternative nicotine products in and on school property, and at school-sponsored events.⁹
• The use of e-cigarettes is prohibited in child residential care facility vehicles. ⁹

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.⁶
• A license is not required to sell e-cigarette products.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.
• While the federal law takes precedence, under the state law, the minimum sales age for South Carolina is 18.
• Underage persons are prohibited from buying and possessing alternative nicotine products, including e-cigarettes.⁶
• The sale or distribution of alternative nicotine products to underage persons is prohibited. ⁹
• Vending machine sale of alternative nicotine products is restricted to locations inaccessible to underage persons or locked and under control of the owner. ⁹
• Internet or remote sales of alternative nicotine products requires third party verification.
• Specialty alternative nicotine shops must prohibit entry to underage persons. ⁹

• The CDC estimates 49.1% of daily adult smokers in South Carolina quit smoking for one or more days in 2019.³
• In 2014, the Affordable Care Act required that Medicaid programs cover all tobacco cessation medications.^7**
• South Carolina’s state quit line invests $5.29 per smoker, compared to the national average of $2.14.⁷
• South Carolina does not have a private insurance mandate provision for cessation.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 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.

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.