Answers About Tobacco

TFN E-News Update / December 2023

ARTICLE: State-Specific Prevalence of Adult
Tobacco Product Use and Cigarette Smoking Cessation Behaviors, United States, 2018–2019

CDC, in collaboration with the National Cancer Institute and the U.S. Food and Drug Administration, released a tobacco-related article titled “State-Specific Prevalence of Adult Tobacco Product Use and Cigarette Smoking Cessation Behaviors, United States, 2018–2019,” in the journal, Preventing Chronic Disease.

Increasing quitting among people who smoke cigarettes is the quickest approach to reducing tobacco-related disease and death. Prevalence of current any tobacco use (use every day or some days) ranged from 10.2% in California to 29.0% in West Virginia. The percentage of adults who currently smoked cigarettes and were interested in quitting ranged from 68.2% in Alabama to 87.5% in Connecticut; made a past-year quit attempt ranged from 44.1% in Tennessee to 62.8% in Rhode Island; reported recent successful cessation ranged from 4.6% in West Virginia and Wisconsin to 10.8% in South Dakota; received advice to quit from a medical doctor ranged from 63.3% in Colorado to 86.9% in Rhode Island; and used medications and/or counseling to quit ranged from 25.5% in Nevada to 50.1% in Massachusetts.

Several states with the highest cigarette smoking prevalence reported the lowest prevalence of interest in quitting, quit attempts, receipt of advice to quit, and use of counseling and/or medication, and the highest prevalence of e-cigarette, smokeless tobacco, and cigar use. Adults who smoke struggle with smoking cessation and could benefit from additional intervention.


CDC Menthol Fact Sheets

CDC’s Office on Smoking and Health has released Menthol Fact Sheets for all 50 states and the District of Columbia. These fact sheets were developed to help OSH awardees and partners with their programmatic planning and educational efforts, given the significant risk menthol cigarettes pose to public health.

The data presented in the fact sheets include:

  • state-specific estimates of the number of adults who currently smoke, usually use menthol cigarettes, and are seriously considering quitting smoking,
  • the economic cost of cigarette smoking in the state,
  • the estimated number of adults in the state who would quit smoking if menthol cigarettes were no longer available,
  • state Medicaid coverage for cessation treatments,
  • state smoking quitline utilization, and
  • the amount of funds CDC provides the state for the quitline.

More information about the data in the Menthol Fact Sheets can be found here: State Menthol Fact Sheets References and Methodology


Counter Tools: Tobacco Retailers
Contracting with Big Tobacco Maps

Counter Tools mapped the retailers required to post corrective statements by zip code and the relative density of retailers required to post corrective statements by state.

View and download the list produced by Campaign for Tobacco Free Kids of retailers participating in corrective action statements here.


Center for Rapid Surveillance of Tobacco — Tracking Confiscated Tobacco Products Project

In an effort to understand and document the rapidly changing tobacco product marketplace and patterns of tobacco use among young people, FDA and NIH have awarded funding for a new project – the Center for Rapid Surveillance of Tobacco led by the Rutgers Center of Excellence in Rapid Surveillance of Tobacco.

The project is launching a system to track tobacco products that are confiscated at schools across the country. This surveillance will help the team identify what products are being used by youth and potentially identify emerging threats.

If you work in a middle or high school and have access to tobacco and/or nicotine products that have been confiscated from students, you can help by uploading photos at the form below.


World Health Organization Calls for Urgent Action Needed to Protect Children and Prevent the Uptake of E-Cigarettes

New guidance released today by the World Health Organization calls for urgent action by governments around the world to address rising rates of youth e-cigarette use and nicotine addiction.

In many countries, including the United States, youth e-cigarette use has become a serious public health problem. As the WHO points out, factors driving youth e-cigarette use include aggressive, youth-oriented marketing and thousands of kid-friendly flavors.

There is no doubt that e-cigarettes are marketed in ways that appeal to youth and that the aggressive tactics of companies like British American Tobacco and other e-cigarette makers are putting kids at risk. A recent report by the Campaign for Tobacco Free Kids on social media marketing by tobacco companies found that British American Tobacco has generated one billion views on social media for its Vuse e-cigarette brand. Nearly half of the audience for Vuse marketing content on social media is under the age of 25. From flavored products to partnerships with influencers and sports brands, e-cigarettes are being tailor-made for young people.

While e-cigarettes have been promoted as a way to help smokers quit traditional cigarettes, the WHO finds that “e-cigarettes as consumer products are not shown to be effective for quitting tobacco use at the population level.”

The World Health Organization calls on governments that ban the sale of e-cigarettes to ensure effective implementation of such policies. For countries that allow the sale of e-cigarettes, the WHO urges governments to implement strict regulations, including prohibiting the sale of flavored products – a position strongly supported by the Campaign for Tobacco Free Kids. In the United States, where over 2 million youth currently use e-cigarettes, nearly 90% of youth e-cigarette users use flavored products.


Counter Tobacco 2023 Point-of-Sale
Tobacco Marketing Photo Contest Winners

Grand Prize Winner
Taken Nov. 7, 2023, in Grand Island, Neb. by Michelle Halpine

This year’s grand prize winner captured the tobacco retail environment today – from the court-ordered tobacco corrective statement about the addictiveness of nicotine above the sprawling powerwall display of tobacco products to the many price discounts advertised and the range of products for sale (cigarettes, smokeless, cigarillos, e-cigarettes and modern oral nicotine products). It shows how tobacco companies are using convenience stores to lure in new customers and keep current ones hooked – by paying them to keep tobacco cheap and visible. Price discounts are the single largest marketing expenditure for tobacco companies, and that’s evident here.


Joint Federal Operation Results in Seizure of More than $18 Million in Illegal E-Cigarettes

Efforts Prevented 1.4 Million Units of Illegal Youth-Appealing E-Cigarettes From Reaching U.S. Market

On Dec. 14, the U.S. Food and Drug Administration, in collaboration with U.S. Customs and Border Protection, announced the seizure of approximately 1.4 million units of unauthorized e-cigarette products, including brands such as Elf Bar, which according to the 2023 National Youth Tobacco Survey, is the most commonly used brand among youth e-cigarette users. The estimated retail value of the seized products totals more than $18 million. The seizures were part of a three-day joint operation, which resulted in the seizure of 41 shipments containing illegal e-cigarettes.

The FDA and CBP conducted the joint operation at a cargo examination site at Los Angeles International Airport, where the team examined incoming shipments for potentially violative items. Upon examining shipments, all of which originated in China, the team found various brands of illegal flavored disposable e-cigarette products.

In addition to Elf Bar, among the seized e-cigarettes were EB Create products; earlier this year, the manufacturer of Elf Bar began marketing the product under the names “EB Design” and “EB Create.” Other seized brands included Lost Mary, Funky Republic, RELX Pod and IPLAY Max, among others. In an attempt to evade duties and detection, many of these unauthorized e-cigarettes were intentionally mis-declared as various items such as toys or shoes and listed with incorrect values.


2023 Monitoring the Future Survey Shows Encouraging Declines in Youth E-Cigarette Use and Increased Risk Perception Among High Schoolers

The findings shared in the 2023 Monitoring the Future Survey are encouraging, highlighting notable decreases in e-cigarette use among high school students. The data show a significant decline from 27.3% to 23.2% among 12th graders and from 20.5% to 17.6% among 10th graders in the past year. Meanwhile, 8th grade use remained relatively stable at 11.4%.

These findings align with 2023 National Youth Tobacco Survey released earlier this year, reinforcing the positive trend. The MTF survey also reports a statistically significant increase in risk perception associated with nicotine for both 10th and 12th graders, and a notably increased disapproval of vaping among 10th graders.


Tobacco Free Nebraska Presents
Nebraska Tobacco Quitline Trainings


This virtual training will use the Million Hearts Tobacco Change Package to discuss practical changes that healthcare systems and clinical teams can make to increase the reach and effectiveness of tobacco cessation interventions and how to incorporate changes into workflows.

View the training flyer for more details.

Dec. 21, 2023, from 11:00 – 11:45 a.m. CT


This virtual training is a resource for community organizations to learn about connecting tobacco users to the Nebraska Tobacco Quitline’s free coaching services and other resources.

View the training flyer for more details.

Jan. 10, 2024, from 12:00 – 1:00 p.m. CT


Brian I.

Brian was in good health, working and managing his infection with HIV—the virus that can cause AIDS—when smoking led to health problems that nearly killed him. Smoking is especially dangerous for people who are living with HIV. For Brian, smoking and having HIV led to clogged blood vessels. At age 43, he had a blood clot in his lungs, a stroke, and surgery on an artery in his neck.

On the day of his stroke, Brian was quickly taken to the hospital and had surgery to clean out a clogged artery in his neck. Regaining use of his body and mind has been a long process that’s still not done. At first, he couldn’t dress himself, brush his teeth or cook. Speaking and reading were difficult.

Today, Brian can manage buttons and shoelaces, as long as he goes slowly. But his right hand is still weak and numb, so he can no longer work as a waiter. After many years as an expert potter, his artistry now looks more like the work of a beginner. Brian’s HIV is under control, as it has been for a long time, but he’s not sure when or if he’ll fully recover from his stroke.

Brian hopes his story will inspire other people to quit smoking before it’s too late. “Having HIV is a part of your life forever,” he says. “Smoking is something that you do have control over. You can stop. And it’s worth your life to stop smoking.”


Tobacco Free Nebraska Quarterly Coalition Meeting
Jan. 24, 2024 | 9:30 – 11:00 a.m. CT
Tobacco Free Nebraska is hosting a virtual State Coalition Meeting on Wednesday, Jan. 24, 2024, from 9:30-11:00 a.m. CT/8:30-10:00 a.m. MT.


Tobacco Cessation and Behavioral Health Workgroup
Jan. 29, 2023 | 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.


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.


Nebraska Tobacco Disparities Partnership Meeting
March 13, 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.


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


  • New Year’s Quit Resolutions
  • Birth Defects Prevention Month
  • Cervical Cancer Awareness Month
  • National Pharmacist Day, Jan. 12, 2024
  • Rev. Dr. Martin Luther King, Jr. Day, Jan. 15, 2024


  • National Cancer Prevention Month
  • Age-Related Macular Degeneration Month
  • Low Vision Awareness Month
  • American Heart Month
  • Black History Month
  • National Burn Awareness Week, Feb. 4-10, 2024
  • Cardiovascular Professionals Week, Feb. 11-17, 2024
  • Through with Chew Week, Feb. 19-23, 2023
  • National Wear Red Day, Feb. 2, 2024
  • World Cancer Day, Feb. 4, 2024
  • Valentine’s Day, Feb. 14, 2024
  • Random Acts of Kindness Day, Feb. 17, 2024
  • Great American Spit Out, Feb. 22, 2024

Nebraska Tobacco Quitline Offers Resources for Healthcare Providers

Accredited courses are now 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.