Tobacco use in Maryland 2023

• In 2022, 9.6% of adults in Maryland smoked. Nationally, adult smoking prevalence was 14.0%.¹
• In 2021, 3.6% of high school students in Maryland smoked cigarettes on at least one day in the past 30 days. Nationally, the rate was 3.8%.²

• In 2022, 4.6% of adults in Maryland used e-cigarettes. Nationally, adult e-cigarette use prevalence was 7.7%¹
• In 2022, 1.8% of adults in Maryland used smokeless tobacco every day or some days. Nationally, adult smokeless tobacco use prevalence was 3.4%¹
• In 2021, 14.7% of high school students in Maryland used electronic vapor products on at least one day in the past 30 days. Nationally, e-cigarette use prevalence among high school students was 18.0%.²
• In 2021, 3.0% of high school students in Maryland used chewing tobacco, snuff or dip on at least one day in the past 30 days. Nationally, smokeless tobacco use prevalence among high school students was 2.5%.²
• In 2021, 3.2% of high school students in Maryland smoked cigars, cigarillos or little cigars on at least one day in the past 30 days. Nationally, cigar use prevalence among high school students was 3.1%.²

• Maryland received $632.1 million (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2022.⁴
• Of this, the state allocated $20.6 million in state funds to tobacco prevention in fiscal year 2022, 42.9% of the Centers for Disease Control and Prevention’s annual spending target.⁴
• Smoking-related health care costs: $3.14 billion per year.⁴
• Smoking-related losses in productivity: $6.4 billion per year.⁵

Tobacco taxes

• Maryland is ranked 5th in the U.S. for its cigarette tax of $3.75 per pack (enacted Feb 2021), compared with the national average of $1.93. (New York has the highest tax at $5.35 and Missouri has the lowest at 17 cents.)^6-8
• Cigars are taxed at 70% of the wholesale price and premium cigars are taxed at 15% of the wholesale price. All other tobacco products are taxed at 53% of the wholesale price.^6,7

Clean indoor air ordinances

• Smoking is prohibited in all government and private workplaces, schools, childcare facilities, restaurants, bars, casinos/gaming establishments, retail stores and recreational/cultural facilities.⁷
• Vaping is prohibited on Maryland Area Regional Commuter (MARC) trains and at MDOT MTA-owned stations.⁹

Flavor restrictions

• The sale of cartridge-based and disposable e-cigarettes with flavors other than menthol is prohibited.¹⁰

Licensing laws

• Retailers and wholesalers are required to obtain a license to sell tobacco products.⁶
• A license is required to sell e-cigarettes.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 electronic smoking devices, including e-cigarettes.^6,7

Local tobacco laws

• Montgomery County, Maryland:
  • Prohibits e-cigarette manufacturers from distributing all e-cigarettes to retail stores within a half mile of a middle or high school.¹⁰
  • Prohibits e-cigarette manufacturers from distributing flavored e-cigarettes to retail stores within a half mile of any middle or high school, library, or recreational facility.¹⁰

• The CDC estimates that 52.3% of daily adult smokers in Maryland 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**
• Maryland’s state quit line invests $4.14 per smoker, compared with the national median of $2.37.⁷
• Maryland does 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 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, 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.

10.       Truth Initiative, Local restrictions on flavored tobacco and e-cigarette products. https://truthinitiative.org/research-resources/emerging-tobacco-products/local-restrictions-flavored-tobacco-and-e-cigarette. Accessed October 4th, 2023.