Tobacco use in Hawaii 2020

• In 2018, 13.4% of adults smoked. Nationally, the rate was 16.1%.1
• In 2019, 5.3% of high school students in Hawaii smoked cigarettes on at least one day in the past 30 days. Nationally, the rate was 6.0%.2

• In 2018, 7.1% of adults in Hawaii used e-cigarettes and 2.8% used smokeless tobacco.3
• In 2019, 30.6% of high school students in Hawaii used electronic vapor products on at least one day in the past 30 days. Nationally, the rate was 32.7%.2

• Hawaii received $154.1 million (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2020.4
• Of this, the state allocated $6.4 million in state funds to tobacco prevention in fiscal year 2020, 46.6% 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 $1.82. (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

Licensing laws

• Retailers and wholesalers are required to obtain a license to sell tobacco products.6
• A license is required to sell e-cigarettes.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.
• 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
• Use of electronic smoking devices prohibited in state parks, on indoor and outdoor areas if Hawaii Health Systems Corporation Property and in enclosed or partially enclosed places that are owned, leased or operated by the state or counties, open to the public, places of employment, sports areas/stadiums, and within 20 feet of entrances and exits to such places.9

• The CDC estimates 47.9% of daily adult smokers in Hawaii quit smoking for one or more days in 2018.3
• 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 $4.39 per smoker, compared with the national average of $2.14.7
• Hawaii does not have a private insurance mandate provision for quitting tobacco.7

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 Behavioral Surveillance System, 2019.

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

4. 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.

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, 2020.

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

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.