Tobacco use in California 2020

• In 2018, 11.2% of adults smoked. Nationally, the rate was 16.1%.¹
• In 2017, 5.4% of high school students in California smoked cigarettes on at least one day in the past 30 days. Nationally, the rate was 8.8% in 2017.²

• In 2017, 3.0% of adults in California used e-cigarettes.³
• In 2018, 1.8% of adults in California used smokeless tobacco.³
• In 2019, 18.2% of high school students in California used electronic vapor products on at least one day in the past 30 days. Nationally, the rate was 32.7%.⁴
• In 2019, 7.6% of high school students in California used chewing tobacco, snuff or dip on at least one day in the past 30 days. Nationally, the rate was 3.8%.⁴

• California received $2.921.1 billion (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2020.⁵
• Of this, the state allocated $326.0 million in state funds to tobacco prevention in fiscal year 2020, 93.7% of the Centers for Disease Control and Prevention’s annual spending target.⁵
• Smoking-related health care costs: $13.29 billion per year.⁵
• Smoking-related losses in productivity: $10.35 billion per year.⁶

Tobacco taxes

• California is ranked 11th in the U.S. for its cigarette tax of $2.87 per pack (enacted April 2017), compared with the national average of $1.82. (The District of Columbia has the highest tax at $4.50 and Missouri has the lowest at 17 cents.) ^7-9
• All other tobacco products are taxed at 65.08% of the wholesale price.^7,8

Clean indoor air ordinances

• Smoking is prohibited in all government and private workplaces, public schools, restaurants, bars, casinos/gaming establishments (tribal establishments exempt), retail stores, recreational/cultural facilities and childcare facilities.⁸
• E-cigarettes are included in the state’s clean indoor air law.¹⁰

Licensing laws

• Retailers, wholesalers, and distributors are required to obtain a license to sell tobacco products.⁷
• Retailers, wholesalers, and distributors are required to obtain a license to sell e-cigarette products.¹⁰

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.
• Establishments are required to post signs stating that sales to minors are prohibited.

Baseball stadium laws

• The use of smokeless tobacco is prohibited in California’s five professional baseball stadiums.⁷

Local tobacco laws

• 71 localities, including Alameda County, Contra Costa County, Long Beach, Los Angeles County, Marin County, Oakland, Sacramento, San Francisco, San Mateo County, Santa Barbara County, Santa Clara County, Santa Cruz County, and Yolo County, prohibit the sale of all flavored tobacco products.¹¹
• 24 other localities have varying restrictions on the sale of flavored tobacco products.¹¹
• 26 localities have banned the sale of all e-cigarettes, with variances for those products that have received FDA premarket approval.¹¹
• 40 cities and counties have banned pharmacies from selling tobacco products, including Alameda County, Contra Costa County, Los Angeles County, Marin County, San Francisco, San Mateo County, Santa Clara County, and Sonoma County.¹²
• Sonoma County requires retailers to sell cigarettes for a minimum of $7 per pack.¹³
• San Francisco caps the number of tobacco sales permits in each of the city’s 11 districts at 45, and new tobacco retailers are prohibited within 500 feet of any school or another retailer.¹⁴

• The CDC estimates 53.4% of daily adult smokers in California quit smoking for one or more days in 2018.³
• In 2014, the Affordable Care Act required that Medicaid programs cover all quit medications.⁸**
• California’s state quit line invests $3.26 per smoker, compared with the national average of $2.14.⁸
• California does not have a private insurance mandate provision for quitting tobacco.⁸

Updated August 2020

*National and state-level prevalence numbers reflect the most recent data available. This 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, 2018.

2. CDC, Youth Risk Behavior Surveillance System, 2017.

3. CDC, Behavioral Risk Factor Surveillance System, State Tobacco Activities Tracking and Evaluation System, 2020.

4. CDC, Youth Risk Behavioral Surveillance System, 2019.

5. Campaign for Tobacco-Free Kids, Broken Promises to Our Children: a State-by-State Look at the 1998 State Tobacco Settlement 21 Years Later FY2020, 2019.

6. Campaign for Tobacco-Free Kids, Toll of Tobacco in the United States.

7. American Lung Association, State Legislated Actions on Tobacco Issues (SLATI).

8. American Lung Association, State of Tobacco Control, 2020.

9. Campaign for Tobacco-Free Kids. State Cigarette Excise Tax Rates & Rankings. https://www.tobaccofreekids.org/assets/factsheets/0097.pdf. Accessed.

10. 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.

11. 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.

12. Americans Nonsmokers' Rights Foundation. Municipalities with Tobacco-Free Pharmacy Laws. http://no-smoke.org/pdf/pharmacies.pdf. Accessed.

13. Sonoma County Code of Ordinances. Chapter 32A: Licensure of Tobacco Retailers. https://www.municode.com/library/ca/sonoma_county/codes/code_of_ordinances?nodeId=CH32ALITORE. Published 2016. Accessed.

14. San Francisco Board of Supervisors. San Francisco Health Code Article 19H. http://www.sfbos.org/ftp/uploadedfiles/bdsupvrs/ordinances14/o0259-14.pdf. Published 2014. Accessed.