Tennessee just flunked Tobacco Control 101, and health advocates say the timing could not be worse.
The American Lung Association’s latest State of Tobacco Control report slaps the Volunteer State with failing marks on nearly every proven policy to prevent tobacco use. Tennessee pulled straight Fs on tobacco taxes, prevention funding, flavored products, and access to quit services, and managed only a D for smoke-free workplace protections. Health groups warn the dismal report card lands in a year when federal tobacco-prevention capacity weakened in 2025, effectively pushing more of the responsibility onto state leaders.
According to the American Lung Association's 24th annual "State of Tobacco Control" report, Tennessee received F grades for funding for state tobacco prevention programs, the level of state tobacco taxes, coverage and access to services to quit tobacco, and ending the sale of flavored tobacco products, and a D for the strength of smokefree workplace laws. The report urges lawmakers to require retailer licensing, protect prevention and cessation funding, and close policy gaps that leave young people exposed to nicotine products.
Tennessee by the numbers
Behind those grim letters are grim statistics: an estimated 11,380 smoking-attributable deaths each year in Tennessee, roughly a 17% adult cigarette smoking rate, and about 20.7% of high school students reporting current tobacco use, as reported by Memphis Flyer. Nationally, youth tobacco use fell to about 2.25 million middle and high school students in 2024, a drop the CDC ties largely to fewer e-cigarette users. But public-health groups warn that without stronger state action, that progress could easily unravel (CDC MMWR).
Federal cuts left states exposed
Advocates say Tennessee’s poor showing is magnified by federal pullbacks that left state systems exposed. Last year saw the virtual elimination of the CDC’s Office on Smoking and Health, steep staffing cuts at the FDA’s Center for Tobacco Products, and months-long delays in appropriated funding that jeopardized quitline and prevention programs. Bloomberg reports that more than 80 public-health organizations pressed HHS to restore the offices and staffing needed to hold retailers and manufacturers accountable.
What advocates want from Nashville
"It is devastating to see the federal government largely abandon its tobacco prevention and cessation efforts," Shannon Baker, Director of Advocacy at the American Lung Association in Tennessee, said in a statement. The ALA is calling on state lawmakers to step into the gap by requiring retailer licensing, raising tobacco taxes, and shoring up quitline funding as the clearest levers to protect young people and reduce preventable deaths.
For Tennessee, the report is more than a bad grade; advocates say it is a roadmap. With federal enforcement thinner, stronger state rules and sustained funding for prevention and cessation are, in their view, the most direct way to keep nicotine out of kids' hands and save lives.
