A newly published report from an anti-tobacco advocacy group gave Texas low grades in 2023 for its efforts to curb tobacco use and support those addicted to nicotine products.

The American Lung Association (ALA), a non-profit organization that promotes lung health, released its annual “State of Tobacco Control” report on January 24. For more than two decades, this annual publication has assessed federal and state actions taken in a given year to curb tobacco use and avoid preventable deaths.

ALA claims that smoking kills over 480,000 Americans each year, making it the leading preventable cause of death. There is also the financial aspect of smoking, which costs the U.S. economy approximately $600 billion in healthcare spending and lost productivity per year.

Moreover, several studies have identified a direct link between smoking and obesity, both of which are known to increase one’s risk of serious health issues and death. Despite some individuals taking up smoking because they think it will help them lose weight, research has linked tobacco use to a thicker waist.

ALA’s analysis centered on five metrics:

  • Tobacco prevention and cessation funding
  • Smokefree air policies
  • Tobacco taxes
  • Access to cessation services
  • Flavored tobacco products

While Alabama and Georgia scored worst overall in the country, with their lawmakers’ efforts to curb tobacco use given F’s across the board, Texas received four F’s and one D grade.

Although ALA applauded Texas for adding over $2.5 million to the budget of its tobacco control program this fiscal year, its overall taxpayer spending amounts to just 3.6% of what the CDC claims is effective.

Moreover, ALA noted that the state took in around $1,7 billion in tobacco-related taxes this fiscal year.

In terms of smoke-free air policies, Texas has none, apart from prohibiting smoking in childcare facilities and restricting it in schools. ALA gave Texas an F for this metric.

Texas received an F rating for average excise taxes on tobacco products. The tax rate on a 20-pack of cigarettes is $1.41. The absence of any restrictions or prohibitions on flavored tobacco products, which tend to be popular among youths, earned the state another F.

Finally, Texas received its highest grade — a D — for access to cessation services, with some anti-smoking medications and counseling covered in its state Medicaid program and state employee healthcare plans.

California, the District of Columbia, and Massachusetts were ranked highest by ALA, despite the latter two being given F’s for lacking tobacco prevention and cessation program funding.

At the federal level, ALA rated the U.S. government subpar on all accounts, with the exception of mass media campaigns. The organization urged the Biden administration to end the sale of menthol cigarettes and flavored cigars and redouble its efforts to prohibit illegal e-cigarettes.