The American Lung Association has released its 24th annual “State of Tobacco Control” report, highlighting concerns about recent federal decisions that could undermine tobacco prevention efforts in the United States. The report states that tobacco use continues to be the leading cause of preventable death and disease in the country, resulting in over 490,000 deaths each year.
In 2025, changes at the federal level included significant cuts to the U.S. Centers for Disease Control and Prevention’s Office on Smoking and Health, staff reductions at the U.S. Food and Drug Administration’s Center for Tobacco Products, and delays in distributing funding authorized by Congress. These actions put state-level tobacco control programs and quitlines at risk, with some states having to reduce or consider shutting down services.
“These unprecedented disruptions will embolden the tobacco industry to expand its predatory marketing and put more lives at risk,” said Harold Wimmer, President and CEO of the American Lung Association. “These decisions are not abstract—they directly affect whether people can access quitline counseling, whether states can run prevention programs that help communities, and whether kids are protected from the next generation of tobacco products. With the federal government reversing long-established tobacco prevention efforts, states must now take the lead. We urge everyone to join our effort and tell policymakers that protecting health must come first.”
The report notes that cigarette smoking costs exceed $600 billion annually due to healthcare expenses and lost productivity. While youth tobacco use is currently at a 25-year low, approximately 2.25 million middle school and high school students continue to use products like e-cigarettes; nearly 90% of these young users choose flavored options.
Adult smoking rates have declined from 23.3% in 2000 to 10.8% in 2023. The report warns that without continued strong prevention measures at both federal and state levels, these gains may be reversed.
For its assessment of federal efforts in five areas related to tobacco control, this year’s report gave an incomplete grade in one category due to unavailable data about a major public campaign’s reach during 2025.
The Lung Association identified five actions for policymakers in Washington to help address death and disease caused by tobacco use.
“The administration has said it wants to reduce chronic disease in both children and adults. This goal cannot be achieved without funding and staffing to address the nation’s leading cause of preventable death and disease: tobacco use. We call on Congress to restore these lifesaving investments,” said Wimmer.
The organization calls for restoring critical programs such as CDC’s Office on Smoking and Health while urging state legislatures to implement robust policies aimed at reducing tobacco use within their communities.
More information about this year’s grades is available at Lung.org/sotc.
The American Lung Association operates as a nonprofit public health organization focused on lung health issues nationwide through research, education, advocacy efforts, community initiatives, policy promotion for clean air, as well as providing resources for patients with lung conditions including asthma and COPD (https://www.lung.org). It originated as an organization addressing tuberculosis but has since expanded its mission across various lung diseases (https://www.lung.org). The association maintains local offices throughout the country (https://www.lung.org) with national headquarters based in Chicago (https://www.lung.org). Under Harold Wimmer's leadership (https://www.lung.org), it has received recognition for fiscal management from Charity Navigator (https://www.lung.org).
