Tobacco use in Maryland 2021

• In 2020, 10.9% of adults smoked. Nationally, the rate was 15.5%.¹
• In 2019, 5.0% of high school students in Maryland smoked cigarettes on at least one day in the past 30 days. Nationally, the rate was 6.0%.²

• In 2019, 3.3% of adults in Maryland used e-cigarettes.
• In 2020, 1.7% of adults in Maryland used smokeless tobacco.³
• In 2019, 23.0% of high school students in Maryland used electronic vapor products on at least one day in the past 30 days. Nationally, the rate was 32.7%.²
• In 2019, 4.6% of high school students in Maryland used chewing tobacco, snuff or dip on at least one day in the past 30 days. Nationally, the rate was 3.8%.²
• In 2019, 6.0% of high school students in Maryland smoked cigars, cigarillos or little cigars on at least one day in the past 30 days. Nationally, the rate was 5.7%.²

• Maryland received $501.0 million (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2021.⁴
• Of this, the state allocated $10.8 million in state funds to tobacco prevention in fiscal year 2021, 22.6% of the Centers for Disease Control and Prevention’s annual spending target.⁴
• Smoking-related health care costs: $2.71 billion per year.⁴
• Smoking-related losses in productivity: $2.22 billion per year.⁵

Tobacco taxes

• Maryland is ranked 5th in the U.S. for its cigarette tax of $3.75 per pack (enacted Feb 2021), compared with the national average of $1.91 (The District of Columbia has the highest tax at $4.50 and Missouri has the lowest at 17 cents.)^6-8
• Cigars are taxed at 70% of the wholesale price and premium cigars are taxed at 15% of the wholesale price. All other tobacco products are taxed at 30% of the manufacturer’s list price.^6,7

Clean indoor air ordinances

• Smoking is prohibited in all government and private workplaces, schools, childcare facilities, restaurants, bars, casinos/gaming establishments, retail stores and recreational/cultural facilities.⁷
• No smoke-free restrictions exist for e-cigarette use.⁹

Flavor restrictions

• The sale of cartridge-based and disposable e-cigarettes with flavors other than menthol is prohibited.¹⁰

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

• Effective December 2019, the United States adopted a law raising the federal minimum age of sale of all tobacco products to 21.  Some states have not yet raised their state minimum age of sale, however, the federal law takes precedence.
• Underage persons are prohibited from buying electronic smoking devices, including e-cigarettes.^6,7
• The sale or distribution of electronic smoking devices or coupons for electronic smoking devices to underage persons is prohibited.⁹
• The sale of flavored electronic smoking devices is prohibited, including disposable products (except tobacco and menthol flavor).⁹
• Vending machine sales of electronic smoking devices is prohibited unless located in an establishment inaccessible to underage persons.⁹

Local tobacco laws

• Montgomery County, Maryland:
  • Prohibits e-cigarette manufacturers from distributing all e-cigarettes to retail stores within a half mile of a middle or high school.¹⁰
  • Prohibits e-cigarette manufacturers from distributing flavored e-cigarettes to retail stores within a half mile of any middle or high school, library, or recreational facility.¹⁰

• The CDC estimates that 52.3% of daily adult smokers in Maryland quit smoking for one or more days in 2019.³
• In 2014, the Affordable Care Act required that Medicaid programs cover all quit medications.⁷**
• Maryland’s state quit line invests $3.74 per smoker, compared with the national average investment per smoker of $2.28.⁷
• Maryland does have a private insurance mandate provision for cessation.⁷

Updated August 2021

*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, 2020.

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

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 22 Years Later FY2021, 2020.

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, 2021.

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.

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.