Tobacco use in Hawaii 2023

• In 2022, 10.0% of adults in Hawaii smoked. Nationally, adult smoking prevalence was 14.0%¹
• In 2021, 3.0% of high school students in Hawaii smoked cigarettes on at least one day in the past 30 days. Nationally, smoking prevalence among high school students was 3.8%.²

• In 2022, 8.8% of adults in Hawaii used e-cigarettes. Nationally, adult e-cigarette use prevalence was 7.7%.¹
• In 2022, 2.1% of adults in Hawaii used smokeless tobacco every day or some days. Nationally, adult smokeless tobacco use prevalence was 3.4%.¹
• In 2021, 14.8% of high school students in Hawaii used electronic vapor products on at least one day in the past 30 days. Nationally, e-cigarette use prevalence among high school students was 18%.²

• Hawaii received $138.2 million (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2022.⁴
• Of this, the state allocated $7.6 million in state funds to tobacco prevention in fiscal year 2022, 55.3% of the Centers for Disease Control and Prevention’s annual spending target.⁴
• Smoking-related health care costs: $611 million per year⁴
• Smoking-related losses in productivity: $1.1 billion per year⁵

Tobacco taxes

• Hawaii is ranked 8th in the U.S. for its cigarette tax of $3.20 per pack (enacted July 2010), compared with the national average $1.93. (New York has the highest tax at $5.35 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 wholesale 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
• 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
• Distribution of samples of electronic smoking devices on public property or within 1000 feet of a school is prohibited.⁹
• Delivery sales of electronic smoking devices require third-party verification, copy of government issued identification or age and signature verification in shipment process upon and before actual delivery.⁹

Local tobacco laws

• 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
• It is prohibited to smoke or use tobacco, including using e-cigarettes, on the premises of the University of Hawaii.¹⁰

• The CDC estimates 42.8% of daily adult smokers in Hawaii quit smoking for one or more days in 2019.³
• 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 $8.83 per smoker, compared with the national median of $2.37.⁷
• Hawaii does not have a private insurance mandate provision for quitting tobacco.⁷

Updated June 2023

* The datasets for both adults and youth prevalence were used to make direct comparisons at the state and national levels. National prevalence reported here may differ from what is reported in our national-level fact sheets. The numbers here also reflect the most recent data available. Dates of available data 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, 2022.

2.         CDC, Youth Risk Behavioral Surveillance System, 2021.

3.         CDC, Behavioral Risk Factor Surveillance System, State Tobacco Activities Tracking and Evaluation System, 2021.

4.         Campaign for Tobacco-Free Kids, Broken Promises to Our Children: a State-by-State Look at the 1998 State Tobacco Settlement 24 Years Later FY2023, 2023.

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, 2023.

8.         Campaign for Tobacco-Free Kids. State Cigarette Excise Tax Rates & Rankings. https://www.tobaccofreekids.org/assets/factsheets/0097.pdf. Accessed October 4th, 2023.

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 October 4th, 2023.

10.         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. Accessed October 4th, 2023