Overview:
Tobacco use claims the lives of more than 11,000 Tennesseans each year.
Tennessee got an F on controlling tobacco use last year, according to the latest annual report from the American Lung Association (ALA).
Tobacco use claims the lives of more than about 11,380 Tennesseans each year, the group said. Nearly 17 percent of adults in Tennessee use at least one tobacco or nicotine product like cigarettes, e-cigarettes or nicotine pouches, according to December data. Around 20 percent of Tennessee high school students use a tobacco product.
The state earned failing or near-failing grades across nearly every category measured by the ALA. It grades states in five policy areas the group says are proven to reduce tobacco use and save lives.
In 2025, Tennessee received the following grades:
• Funding for state tobacco prevention programs: F
• Level of state tobacco taxes: F
• Strength of smoke free workplace laws: D
• Coverage and access to services to quit tobacco: F
• Ending the sale of all flavored tobacco products: F
The report says Tennessee has to step up efforts to reduce nicotine use — including e-cigarettes and nicotine pouches — especially as federal tobacco prevention efforts were dramatically rolled back in 2025. Tobacco use remains the nation’s leading cause of preventable death and disease, the ALA said.
The report urges Tennessee lawmakers to require all retailers that sell nicotine products to obtain licenses, arguing that retail licensing is a critical tool to curb youth access and improve enforcement.
Federal actions in 2025 significantly weakened tobacco prevention nationwide, including the effective elimination of the CDC’s Office on Smoking and Health, major staffing cuts at the FDA’s Center for Tobacco Products, and delays in Congressionally approved funding. As a result, quitting hotlines and prevention programs in all 50 states were placed at risk, with some states scaling back lifesaving services.
“It is devastating to see the federal government largely abandon its tobacco prevention and cessation efforts,” said Shannon Baker, the ALA’s director of advocacy in Tennessee. “States need to ramp up their efforts even more to protect residents from disease and addiction caused by nicotine use.”