Tobacco use in Tennessee 2020

• In 2018, 20.7% of adults smoked. Nationally, the rate was 16.1%.¹
• In 2019, 7.1% of high school students in Tennessee smoked cigarettes on at least one day in the past 30 days. Nationally, the rate was 6.0%.²

• In 2018, 5.6% of adults in Tennessee used e-cigarettes and 5.8% used smokeless tobacco.³
• In 2019, 22.1% of high school students in Tennessee used electronic vapor products on at least one day in the past 30 days. Nationally, the rate was 32.7%.²
• In 2019, 8.2% of high school students in Tennessee 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, 9.1% of high school students in Tennessee smoked cigars, cigarillos or little cigars on at least one day in the past 30 days. Nationally, the rate was 5.7%.²

• Tennessee received $424 million (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2020.⁴
• Of this, the state allocated $2.0 million in state funds to tobacco prevention in fiscal year 2020, which is 2.6% of the Centers for Disease Control and Prevention’s annual spending target.⁴
• Smoking-caused health care costs: $2.67 billion per year.⁴
• Smoking-caused losses in productivity: $3.59 billion per year.⁵

Tobacco laws

• Tennessee is ranked 43rd in the U.S. for its cigarette tax of 62 cents per pack (enacted July 2007), compared to 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
• All other tobacco products are taxed at 6.6% of the wholesale cost price.^6,7

Clean indoor air ordinances

• Smoking is prohibited in government workplaces, private workplaces (non-public workplaces with three or fewer employees exempt), schools, childcare facilities, retail stores and recreational/cultural facilities.^6,7
• Smoking is allowed in restaurants and bars that do not allow persons under 21 to enter at any time.^6,7
• There are no restrictions for casinos/gaming establishments.⁷  
• The use of e-cigarettes is prohibited in areas where children are allowed in child care centers, any room or area in a community center while the area is used for children’s activities, in group care homes, healthcare facilities, museums, schools, school grounds, residential treatment facilities for children and youth, youth development centers, and zoos.⁹
• The use of e-cigarettes is prohibited at Tennessee Technological University and nearby Cookeville student housing.⁹

Licensing laws

• Retailers and wholesalers are required to obtain a license to sell tobacco products.
• Retailers and wholesalers are not required to obtain a license 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.
• Minors are prohibited from buying bidis and/or e-cigarettes.⁶
• Establishments are required to post signs stating that sales to minors are prohibited.⁶

• The CDC estimates 50.2% of daily adult smokers in Tennessee quit smoking for one or more days in 2018.³
• In 2014, the Affordable Care Act required that Medicaid programs cover all tobacco cessation medications.^7**
• Tennessee’s state quit line invests $2.34 per smoker, compared to the national average of $2.14.⁷
• Tennessee does not have a private insurance mandate provision for cessation.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 cessation 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 Behavioral Surveillance System, 2019.

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

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, 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.