Tobacco use in South Carolina 2023

• In 2022, 15.4% of adults smoked. Nationally, adult smoking prevalence was 14.0%.¹
• In 2021, 3.3% of high school students in South Carolina smoked cigarettes on at least one day in the past 30 days. Nationally, smoking prevalence among high school students was 3.8%.²

• In 2022, 8.2% of adults in South Carolina used e-cigarettes. Nationally, adult e-cigarette use prevalence was 7.7%.¹
• In 2022 3.3% of adults in South Carolina used smokeless tobacco every day or some days. Nationally, adult smokeless tobacco use prevalence was 3.4%. ¹
• In 2021, 16.7% of high school students in South Carolina 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 18%.²
• In 2021, 2.2% 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 smokeless tobacco use prevalence among high school students was 2.5%.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 cigar use prevalence among high school students was 5.7%.²

• South Carolina received $226.9 million (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2023.⁴
• Of this, the state allocated $5.0 million in state funds to tobacco prevention in fiscal year 2023, 9.8% of the Centers for Disease Control and Prevention’s annual spending target.⁴
• Smoking-caused health care costs: $2.21 billion per year.⁴
• Smoking-caused losses in productivity: $5.7 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 $1.93. (New York has the highest tax at $5.35 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

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

• 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 nicotine products, including e-cigarettes. Specialty alternative nicotine shops must prohibit minors from entering.^6,9
• Vending machine sales of alternative nicotine products is restricted to locations inaccessible to persons under 18 or locked and under control of the owner.⁹
• Internet or remote sales of alternative nicotine products requires third party age verification.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 $6.20 per smoker, compared to the national median of $2.37.⁷
• South Carolina does not have a private insurance mandate provision for cessation.⁷

Updated June 2023

* 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.

1.         CDC, Behavioral Risk Factor Surveillance System, 2022.

2.         CDC, Youth Risk Behavioral Surveillance System, 2021.

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 24 Years Later FY2023, 2023.

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, 2023.

8.         Campaign for Tobacco-Free Kids. State Cigarette Excise Tax Rates & Rankings. https://www.tobaccofreekids.org/assets/factsheets/0097.pdf. Accessed October 4th, 2023.

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 October 4th, 2023.