What federal health agency cuts mean for tobacco control

On April 1, the U.S. Department of Health and Human Services (HHS) announced sweeping cuts that have profound impacts on federal tobacco control efforts. Many foundational systems supporting tobacco use prevention, cessation, research, and public education have been substantially reduced or eliminated entirely.

These cuts include eliminating the Office on Smoking and Health at the Centers for Disease Control and Prevention and significantly scaling back the Center for Tobacco Products at the Food and Drug Administration, agencies that regulate tobacco products and monitor and attempt to reduce tobacco use. 

On May 5, twenty state attorneys general filed a lawsuit against the cuts at the U.S. Department of Health and Human Services, challenging the Trump administration's unconstitutional dismantling of the department and urging the court to restore these critical public health programs.

Based on multiple sources, here is the latest information about cuts to federal tobacco control efforts.

CDC Office on Smoking and Health

The CDC Office on Smoking and Health plays a critical role in preventing youth tobacco use and helping adult tobacco users to quit. 

As of May 30, due to a preliminary injunction issued by a federal district judge, the Trump administration is pausing the layoffs at CDC, including the Office on Smoking and Health. Those affected will remain on paid administrative leave until further notice.

Layoffs, extended administrative leave, and potential elimination of CDC OSH puts the following programs at risk:

Public education:

• The Tips from Former Smokers® public education campaign encourages people who smoke to quit by featuring real people living with serious long-term health effects from smoking and secondhand smoke exposure. They share the impact smoking has had on their lives—and the lives of their loved ones. During 2012-2018, The Tips campaign helped over one million people successfully quit and helped save an estimated $7.3 billion in smoking-related healthcare costs.
• As of May 21, loss of federal funding from CDC OSH has led to the scheduled closure (summer 2025) of a youth-led tobacco prevention program in West Virginia.

State tobacco control funding and assistance:

• CDC OSH is the only federal agency that provides funding and technical assistance to state and territorial health departments for tobacco control efforts.
  • For every $1 spent on comprehensive tobacco control programs, states get a $55 return on investment, mostly in averted health care costs to treat smoking-related illness.
  • Without funding from CDC OSH, states would lose approximately $69 million in funding for their tobacco control programs. Currently, states receive funding from OSH each year, ranging from $343,000 to $2.3 million, based on population size, rates of tobacco use, and other state-specific factors.
  • Without funding from CDC OSH, states would lose approximately $16 million in funding for their state quitlines. Quitlines in 23 states and 2 territories rely on CDC for at least a quarter of their funding; 5 of these states and the 2 territories rely on CDC for at least 75% of their funding.
  • As of May 21, loss of federal funding from CDC OSH has led to the indefinite furlough of nine staff working at North Carolina's tobacco prevention and control program leaving only three state-level employees to continue tobacco prevention efforts. This could limit quitline services, including those that provide nicotine replacement therapy (NRT) for uninsured and underinsured North Carolinians, and scale back Tobacco-Free NC initiatives. New York State has also had to lay off 13 tobacco control program staff. 

Data collection and evaluation:

• CDC OSH funds data collection, evaluation, research, and lab activities that monitor tobacco use and its health effects. CDC OSH and FDA conduct the National Youth Tobacco Survey, which collects data on tobacco use by high school and middle school students, including which products they are using, how often they use them, and how youth access them.

FDA Center for Tobacco Products

The FDA Center for Tobacco Products regulates the manufacturing, marketing, and distribution of tobacco products and educates the public about the dangers of using tobacco products. FDA CTP is completely funded by tobacco user fees collected from domestic manufacturers and importers of cigarettes, snuff, chewing tobacco, roll-your-own tobacco, cigar, and pipe tobacco. Thus, there is no savings to American taxpayers with these layoffs. Here is what we know about the reductions in workforce at the center:

Leadership and staff:

• CTP Director Brian King was placed on administrative leave.
• The leadership of the Office of Science, responsible for the review of tobacco products, was removed.
• The office responsible for conducting public education, stakeholder outreach, and regulatory communication programs had layoffs to its leadership and staff working on public education campaigns.
• Staff responsible for issuing warnings letters and penalties to retailers selling tobacco products to underage people were laid off and have since been asked to temporarily return
• The regulations division, which issues regulations regarding tobacco products and guidance documents for the tobacco industry, was cut essentially entirely.
• The management division was cut entirely, which is responsible for overseeing the center’s administrative services and operations.
• According to a motion for preliminary injunction, FDA CTP has paused compliance checks to ensure tobacco products are not sold to minors and has paused review of premarket applications of tobacco products.

While it is currently unclear how these reductions in workforce at FDA Center for Tobacco Products will impact its work exactly, it is clear that the agency has less staff to enforce current regulations and will likely result in more tobacco products coming on the market and almost no new regulations issued to further its mission of reducing tobacco-related death and disease.