Tobacco use in Tennessee 2023

• In 2022, 18.5% of adults smoked. Nationally, adult smoking prevalence was 14.0%.¹
• In 2021, 4.9% of high school students in Tennessee 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, 10.8% of adults in Tennessee used e-cigarettes. Nationally, adult e-cigarette use prevalence was 7.7%.¹
• In 2022, 5.4% of adults in Tennessee used smokeless tobacco every day or some days. Nationally, adult smokeless tobacco use prevalence was 3.4%¹
• In 2021, 19.0% of high school students in Tennessee 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, 3.1% of high school students in Tennessee 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 2021, 4.4% of high school students in Tennessee 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 3.1 was 5.7%.²

• Tennessee received $406.3 million (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2023.⁴
• Of this, the state allocated $2 million in state funds to tobacco prevention in fiscal year 2023, which is 2.6% of the Centers for Disease Control and Prevention’s annual spending target.⁴
• Smoking-caused health care costs: $3.10 billion per year.⁴
• Smoking-caused losses in productivity: $8.5 billion per year.⁵

Tobacco taxes

• Tennessee is ranked 43rd in the U.S. for its cigarette tax of 62 cents per pack (enacted July 2007), 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 6.6% of the wholesale cost price.^6,7

Clean indoor air ordinances

• Smoking is prohibited in government workplaces, private workplaces (non-public workplaces with three or fewer employees exempt), schools, childcare facilities, retail stores and recreational/cultural facilities.^6,7
• Smoking is allowed in restaurants and bars that do not allow persons under 21 to enter at any time.^6,7
• E-cigarettes are included in the state’s definition of smoking.⁷
• The use of e-cigarettes is prohibited at Tennessee Technological University, nearby Cookeville student housing, and on the grounds of Austin Peay State University. It is also prohibited in Sullivan County courts.⁹

Licensing laws

• Retailers and wholesalers are required to obtain a license to sell tobacco products.
• Retailers and wholesalers are not required to obtain a license 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 bidis and/or e-cigarettes.⁶
• Establishments are required to post signs stating that sales to minors are prohibited.⁶
• Self-service displays of vapor products are prohibited. Vending machine sales must be inaccessible to persons under 21, or in other places where under continuous supervision or operated by token.⁹
• The distribution of free vapor products/samples is prohibited “on any public street, sidewalk, or park”.⁹

• The CDC estimates 47.0% of daily adult smokers in Tennessee 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**
• Tennessee’s state quit line invests $0.43 per smoker, compared to the national median of $2.37.⁷
• Tennessee 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, 2023.

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

3.         CDC, Behavioral Risk Factor Surveillance System, State Tobacco Activities Tracking and Evaluation System, 2023.

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