Answers About Tobacco

TFN E-News Update / April 2024

Morbidity and Mortality Weekly Report: State Medicaid Coverage for Tobacco Cessation Treatments and Barriers to Accessing Treatments — United States, 2018–2022

On April 11, 2024, the CDC’s Office on Smoking and Health and the American Lung Association released a tobacco-related article in the journal, Morbidity and Mortality Weekly Report titled, “State Medicaid Coverage for Tobacco Cessation Treatments and Barriers to Accessing Treatments—United States, 2018–2022.”

In the article:

  • Cigarette smoking is more common among adults enrolled in Medicaid than adults with private insurance. Evidence-based tobacco cessation treatments—and comprehensive and barrier-free insurance coverage of those treatments—can increase quitting.
  • As of December 2022, Medicaid programs in 20 states provided comprehensive coverage for all evidence-based tobacco cessation treatments; of these, only three had zero barriers to access.
  • State Medicaid programs can improve the health of enrollees who smoke—and potentially reduce health care expenditures—by providing barrier-free coverage for all evidence-based tobacco cessation treatments and by promoting this coverage to enrollees and providers.
  • CDC is at the forefront of national efforts to reduce deaths and prevent chronic diseases that result from tobacco use.

Graphic Warning Labels Required on Cigarette Packaging

On March 21, 2024, the Fifth Circuit upheld the U.S. Food and Drug Administration’s mandate for graphic health warning labels on cigarette packaging and advertising in R.J. Reynolds v. FDA, marking a pivotal win for public health. This ruling overturns a prior decision by a lower court.

The center of this legal challenge was the FDA’s 2020 regulation requiring 11 distinct graphic warnings on cigarette packages and advertisements. The FDA’s rule requires labels depicting the various harmful health effects of smoking. For example, one warning depicts an image of a child with a nebulizer and an accompanying statement that “tobacco smoke can harm your children.” The court rejected arguments from R.J. Reynolds that the labels violate the First Amendment or take up too much space on packages. In upholding the graphic warning labels, the Fifth Circuit determined that the warnings are “factual and uncontroversial” and promote a legitimate government interest.

ARTICLE: Exposure Among Middle and High School Students to Warning Labels on E-Cigarette Packages Before and After an FDA Requirement, 2018–2019

A recent CDC analysis of 2018 and 2019 National Youth Tobacco Survey data, published in Preventing Chronic Disease, concluded that after the implementation of the FDA’s rule requiring all e-cigarette packages to have a health warning, the percentage of current tobacco users and e-cigarette users among middle and high school students who reported any and high exposure to e-cigarette warning labels increased.

Ten Years of No Menthol Sunday
“Rooted in Power: A Decade of Determination”

This May 19, The Center for Black Health & Equity is celebrating the 10th year of No Menthol Sunday, which is an annual opportunity for faith communities to address the detrimental impact tobacco is having on African American communities. Each year on the third Sunday of May, faith leaders are encouraged to dedicate this day to educating congregants about smoking, vaping and the role of menthol and other flavors.

Visit the No Menthol Sunday website for the toolkit, resources for digital campaigns and social media, announcements for religious services, and ideas on how to spread awareness about the event.

No Limits Nebraska: Youth Leadership Team

Applications for the No Limits Youth Leadership Team are open! No Limits Nebraska is calling on incoming 9th through 11th graders from all corners of Nebraska to apply and join a movement to take down big tobacco. This team will be the guiding force that pushes the movement forward by empowering other Nebraska youth. Learn more about the application requirements and apply today!

Applications close on May 10 at 11:59 p.m.

Want to subscribe to No Limits Nebraska’s quarterly newsletters? Email Ranae Aspen at

FDA Updates

  • On March 28, the FDA launched the Searchable Tobacco Products Database, a new user-friendly list of tobacco products, including e-cigarettes, that may be legally marketed in the United States. The database is designed to serve the public, especially retailers, by providing this key information in a single location, with easy-to-use search capabilities. The database will be updated on a monthly basis.
  • On April 2, the FDA released several scientific review policy memoranda that provide a snapshot of the FDA’s internal thinking on certain topics within the premarket tobacco review process. This action is consistent with commitments made by CTP to post scientific policy memos and reviewer guides, as appropriate, in response to the 2022 Reagan-Udall Foundation’s operational evaluation of the center.
  • On April 4, the FDA announced the issuance of 119 warning letters to, and the filing of 41 civil money penalty complaints against, brick and mortar retailers that engaged in the underage sale of various flavors of ZYN nicotine pouches between October 2023 and February 2024. FDA has also issued warning letters to three online retailers for the sale of unauthorized, flavored ZYN nicotine pouches, including Espressino, Black Cherry, Lemon Spritz, and Cucumber Lime.
  • On April 15, the FDA issued marketing denial orders (MDOs) to Shenzhen Yibo Technology Co. Ltd. for 65 disposable e-cigarettes marketed as “MNGO Disposable Stick.” As a result, the company must not market or distribute these products in the United States or they risk FDA enforcement action.
  • On April 16, Nature Medicine published a new commentary co-authored by FDA’s Center for Tobacco Products (CTP) Director Brian King, Ph.D., M.P.H., discussing considerations for healthcare providers around talking to adults about the relative risks of different tobacco products. In conjunction with the commentary, CTP is launching a new webpage aimed at educating the public about the relative risks of tobacco products. CTP will continue to update the information on this new webpage based on the best available science.

Tobacco Free Nebraska Presents
Nebraska Tobacco Quitline Trainings

Terrie H.

In high school, Terrie was a pretty cheerleader who competed on the cheer circuit. Her father smoked, and with more and more of her friends smoking, Terrie soon found herself smoking in social settings. Eventually, she was smoking up to two packs a day.

In 2001, at the age of 40, Terrie was diagnosed with oral cancer, and later that same year, with throat cancer. Doctors informed her that they would need to remove her larynx. It was then that she quit smoking for good. Terrie spoke with the aid of an artificial voice box that was inserted in her throat. She continued to battle cancer with a strong, positive spirit. Terrie died in 2013 at age 53 from smoking-related cancer.

Tobacco Cessation and Behavioral Health Workgroup
April 29, 2024 | 2:00 – 3:30 p.m. CT
During these quarterly virtual meetings, individuals will focus on the workgroup’s mission to collaborate, establish projects for the workgroup, share resources and align goals across the state of Nebraska, with the aim of increasing tobacco cessation programming in behavioral health services.

SAVE THE DATE: Nebraska State Tobacco Control Conference
May 15, 2024 | 9:00 a.m. – 4:00 p.m.
Tobacco Free Nebraska is hosting an in-person state tobacco control conference at the smoke-free Graduate Hotel in Lincoln, NE.

View the presentation lineup for more information. Registration link will be available soon.

Nebraska Tobacco Disparities Partnership Meeting
June 26, 2024 | 2:30-3:30 p.m. CT
The Nebraska Tobacco Disparities Partnership is a vibrant network of people and organizations from across the state that focuses on reducing tobacco-related disparities among Nebraska’s diverse populations. The Nebraska Tobacco Disparities Partnership works to provide the information, resources and support that these populations need to prevent youth from using tobacco, and to help current tobacco users quit.

Michael Scott, Program Manager of The Center for Black Health and Equity, will present on communicating health disparities effectively.

Tobacco Disparities Reframing Project
OPEN NOW | Virtual
The CDC Office on Smoking and Health’s training resource to help the tobacco control community use new evidence-based framing and messaging.

National Tribal Tobacco Conference
June 27-28, 2024 | Minneapolis, MN
This conference will address the traditional uses of tobacco and commercial tobacco impact in American Indian and Alaska Native (AI/AN) communities across the United States, and will emphasize AI/AN persons returning to a healthy relationship with tobacco, the importance of creating health equity, and provide an opportunity for networking and collaboration.

American Nonsmokers’ Rights Foundation Clearing the Air Institute
Oct. 14-17, 2024 | Philadelphia, PA
Clearing the Air® Institute focuses on smoke-free air and gaps in protections, and features specific information on smoke-free workplaces, secondhand smoke and e-cigarette aerosol, multi-unit housing, marijuana, casinos, menthol and flavors, colleges, and more.

Nebraska DHHS Division of Public Health, Office of Health Disparities: Eliminating Health Disparities Conference
Oct. 16-17, 2024 | York, NE
The Eliminating Health Disparities in Nebraska conference will share successful programming and services which address and reduce health disparities in Nebraska in the areas of physical/mental health, social/spiritual well-being, community conditions, root causes, and organization transformation skills.

SAVE THE DATE: National Conference on Tobacco or Health
Aug. 26-28, 2025 | Chicago, Illinois
The National Conference on Tobacco or Health is one of the largest, long-standing gatherings for top United States tobacco control professionals.

This convening attracts a diversity of attendees committed to best practices and policies to reduce tobacco use, which is the leading preventable cause of disease and death in the United States.

FREE Resources Available through the Nebraska Tobacco Quitline Order Form

This online order form provides the option to preview, order, download and print free and updated promotional resources such as brochures, window clings, magnets, information sheets and more with information about the Nebraska Tobacco Quitline. Most materials are available in both Spanish and English. Please order or use these free materials as needed.

Upcoming Monthly Health Observances and Awareness Days


  • Arthritis Awareness Month
  • Asian American and Pacific Islander Heritage Month
  • Asthma and Allergy Awareness Month
  • Bladder Cancer Awareness Month
  • Clean Air Month
  • Employee Health and Fitness Month
  • Graduation Season
  • Healthy Vision Month
  • High Blood Pressure Education Month
  • Older Americans Month
  • Stroke Awareness Month
  • Air Quality Awareness Week, May 6-10, 2024
  • Mental Health Awareness Month and National Prevention Week, May 12-18, 2024
  • National Nurse’s Week, May 6-12, 2024
  • National Women’s Health Week and Women’s Lung Health Week, May 12-18, 2024
  • Mother’s Day, May 12, 2024
  • National Women’s Check-Up Day, May 13, 2024
  • No Menthol Sunday, May 19, 2024
  • Memorial Day, May 27, 2024
  • National Senior Health and Fitness Day, May 29, 2024
  • National Smile Day, May 31, 2024
  • World No Tobacco Day, May 31, 2024

Nebraska Tobacco Quitline Offers
Resources for Healthcare Providers

Accredited courses are available online through the Nebraska Tobacco Quitline for providers looking to receive CME, CNE or CPE credits. Every year, providers in Nebraska support patients quitting tobacco by referring them to the Quitline. The courses offered help providers discuss how cessation can increase quit success and reduce the risks associated with tobacco use, including vaping. Several courses are offered and cover a variety of topics, such as Tobacco Use Disparities for People with Behavioral Health Conditions, Myths About Quitting, Vaping and E-Cigarette Devices, and more.

Additionally, providers can refer patients using the new online web referral option or the updated fax referral form. Go online to access tools, resources, and education modules, plus the web and fax referrals for providers ready to help patients quit, at

Call 1-800-QUIT-NOW or visit to reach a trained quit coach, get access to free quit-smoking medication, and make a plan to quit tobacco for good.