Tobacco use in Hawaii 2019

• In 2017, 12.8% of adults smoked. Nationally, the rate was 17.1%.¹
• In 2017, 8.1% of high school students in Hawaii smoked cigarettes on at least one day in the past 30 days. Nationally, the rate was 8.8%.²

• In 2017, 4.7% of adults used e-cigarettes and 2.6% used smokeless tobacco.³
• In 2017, 25.5% of high school students in Hawaii used electronic vapor products on at least one day in the past 30 days. Nationally, the rate was 13.2%.²

• Hawaii received $160.3 million (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2019.³
• Of this, the state allocated $4.5 million in state funds to tobacco prevention in fiscal year 2019, 32.9% of the Centers for Disease Control and Prevention’s annual spending target.⁴
• Smoking-related health care costs: $526 million per year⁴
• Smoking-related losses in productivity: $387.3 million per year⁵

Tobacco taxes

• Hawaii is ranked 6th in the U.S. for its cigarette tax of $3.20 per pack (enacted July 2010), compared with the national average of $1.81. (The District of Columbia has the highest tax at $4.50 and Missouri has the lowest at 17 cents.)^6-8
• Little cigars are taxed at 15 cents per cigar and large cigars are taxed at 50% of the wholesale prices. All other tobacco products are taxed at 70% of the manufacturer’s list price.^6,7

Clean indoor air ordinances

• Smoking is prohibited in all government workplaces, private workplaces, schools, childcare facilities, restaurants, bars, retail stores and recreational/cultural facilities.^6,7
• There are no smoking restrictions in casino/gaming establishments.⁷
• E-cigarettes are included in the state’s definition of smoking.⁹

Youth access laws

• The minimum age to purchase tobacco products in Hawaii is 21. 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.^6,7
• Minors are prohibited from buying electronic smoking devices, including e-cigarettes.⁶

• The CDC estimates 48.9% of daily adult smokers in Hawaii quit smoking for one or more days in 2017.¹⁰
• In 2014, the Affordable Care Act required that Medicaid programs cover all quit medications. However, there is not yet evidence that the Hawaii Medicaid program has complied with this requirement regarding NRT nasal spray, NRT lozenge and NRT inhaler.⁷**
• Hawaii’s state quit line invests $5.03 per smoker, compared with the national average of $2.21.⁷
• Hawaii does not have a private insurance mandate provision for quitting tobacco.⁷

Updated April 2019

*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, 2017.

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

3. Hu SS, Homa DM, Wang T, et al. State-Specific Patterns of Cigarette Smoking, Smokeless Tobacco Use, and E-Cigarette Use Among Adults - United States, 2016. Preventing chronic disease. 2019;16:E17.

4. Campaign for Tobacco-Free Kids, Broken Promises to Our Children: a State-by-State Look at the 1998 State Tobacco Settlement 20 Years Later FY2019, 2018.

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, 2019.

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

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.

10. CDC, Behavioral Risk Factor Surveillance System, State Tobacco Activities Tracking and Evaluation System, 2017.