Tobacco use in Iowa 2023

• In 2022, 14.7% of adults in Iowa smoked. Nationally, adult smoking prevalence was 14.0%.¹
• In 2021, 4.1% of high school students in Iowa 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, 6.7% of adults in Iowa used e-cigarettes. Nationally, adult e-cigarette use prevalence was 7.7%¹
• In 2022, 5.3% of adults in Iowa used smokeless tobacco every day or some days. Nationally, adult smokeless tobacco use prevalence was 3.4%¹
• In 2021,16.4% of high school students in Iowa used electronic vapor products on at least one day in the past 30 days. Nationally, the rate was 18%.²
• In 2021, 2.3% of high school students in Iowa used chewing tobacco, snuff or dip on at least one day in the past 30 days. Nationally, the rate was 2.5%.²
• In 2021, 2.4% of high school students in Iowa smoked cigars, cigarillos or little cigars on at least one day in the past 30 days. Nationally, the rate was 3.1%.²

• Iowa received $256.7 million (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2022.⁴
• Of this, the state allocated $4.3 million in state funds to tobacco prevention in fiscal year 2022, 14.2% of the Centers for Disease Control and Prevention’s annual spending target.⁴
• Smoking-related health care costs: $1.49 billion per year⁴
• Smoking-related losses in productivity: $3.1 billion per year⁵

Tobacco taxes

• Iowa is ranked 32nd in the U.S. for its cigarette tax of $1.36 per pack (enacted March 2007), compared with the national average of $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 $1.36 per 20 cigars, snuff is taxed at $1.19 per ounce and all other tobacco products are taxed 50% of the wholesale sales 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
• Smoking restrictions are required in casinos/gaming establishments (tribal establishments are exempt).^6,7
• E-cigarettes are not included in the state’s smoke-free restrictions. The use of e-cigarettes is prohibited on state-owned buildings and grounds, on the campus of Iowa State University and the University of Iowa, in foster homes and vehicles when a foster child is present, and in cars carrying food orders placed through a food delivery platform.^7,9

Licensing laws

• Retailers and wholesalers are required to obtain a license to sell tobacco products.⁶
• A license is required to sell e-cigarette products.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.
• Those under 21 years are prohibited from buying alternative tobacco products, including e-cigarettes.^6,7,9
• Distribution of free vapor products to persons under age 21 or within 500 feet of places when they are primarily in use by minors is prohibited.⁹
• Retailers making delivery sale of vapor products must use a method that requires the signature of a person at least 21 years of age before the package is released.⁹

Local tobacco laws

• Iowa City prohibits the use of tobacco products, including electronic cigarettes and chewing tobacco, throughout all parks except in privately owned vehicles.¹⁰

• The CDC estimates 42.4% of daily adult smokers in Iowa quit smoking for one or more days in 2019.³
• In 2014, the Affordable Care Act required Medicaid programs cover all quit medications.⁷**
• Iowa’s state quit line invests $1.22 per smoker, compared with the national median of $2.37.⁷
• Iowa does not have a private insurance mandate provision for quitting tobacco.⁷

Updated June 2023

*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, 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 42 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