Tobacco use in Iowa 2021

• In 2020, 15.8% of adults smoked. Nationally, the rate was 15.5%.¹
• In 2019, 6.7% of high school students in Iowa smoked cigarettes on at least one day in the past 30 days. Nationally, the rate was 6.0%.²

• In 2018, 5.3% of adults in Iowa used e-cigarettes.³
• In 2020, 4.4% of adults in Iowa used smokeless tobacco.³
• In 2019, 20.1% of high school students in Iowa used electronic vapor products on at least one day in the past 30 days. Nationally, the rate was 32.7%.²
• In 2019, 4.9% of high school students in Iowa used chewing tobacco, snuff or dip on at least one day in the past 30 days. Nationally, the rate was 3.8%.²
• In 2019, 4.4% of high school students in Iowa smoked cigars, cigarillos or little cigars on at least one day in the past 30 days. Nationally, the rate was 5.7%.²

• Iowa received $266.6 million (estimated) in revenue from tobacco settlement payments and taxes in fiscal year 2021.⁴
• Of this, the state allocated $4.0 million in state funds to tobacco prevention in fiscal year 2021, 13.4% of the Centers for Disease Control and Prevention’s annual spending target.⁴
• Smoking-related health care costs: $1.28 billion per year⁴
• Smoking-related losses in productivity: $1.21 billion per year⁵

Tobacco taxes

• Iowa is ranked 32nd in the U.S. for its cigarette tax of $1.36 per pack (enacted March 2007), compared with the national average of $1.91. (The District of Columbia has the highest tax at $4.50 and Missouri has the lowest at 17 cents.) ^6-8
• Little cigars are taxed at $1.36 per 20 cigars, snuff is taxed at $1.19 per ounce and all other tobacco products are taxed 50% of the manufacturer’s list price.^6,7

Clean indoor air ordinances

• Smoking is prohibited in all government workplaces, private workplaces, schools, childcare facilities, restaurants, bars, retail stores and recreational/cultural facilities.^6,7
• Smoking restrictions are required in casinos/gaming establishments (tribal establishments are exempt).^6,7
• The use of e-cigarettes is prohibited on state-owned buildings and grounds, on the campus of Iowa State University and the University of Iowa, and in foster homes and vehicles when a foster child is present.⁹

Licensing laws

• Retailers and wholesalers are required to obtain a license to sell tobacco products.⁶
• A license is required to sell e-cigarette products.⁹

Youth access laws

• Effective December 2019, the United States adopted a law raising the federal minimum age of sale of all tobacco products to 21.  Some states have not yet raised their state minimum age of sale, however, the federal law takes precedence.
• Underage persons are prohibited from buying, possessing, or using vapor products, including e-cigarettes.^{6,7, 9}
• The sale or distribution of vapor products to any underage persons is prohibited.
• There is no distribution of free vapor products to underage persons or within 500 feet of places when primarily used by minor.⁹
• Self-service displays of vapor products is restricted to locations inaccessible to underage persons.⁹
• Vending machine sales of vapor products is restricted to locations inaccessible to underage persons.⁹
• Retailers making delivery sales of vapor products must use methods that require the signature of a person at least 21 years old before the package is released.⁹

• The CDC estimates 42.4% of daily adult smokers in Iowa quit smoking for one or more days in 2019.³
• In 2014, the Affordable Care Act required Medicaid programs cover all quit medications.⁷**
• Iowa’s state quit line invests $1.04 per smoker, compared with the national average of $2.28.⁷
• Iowa does not have a private insurance mandate provision for quitting tobacco.⁷

Updated August 2021

*National and state-level prevalence numbers reflect the most recent data available. This may differ across state fact sheets.

**The seven recommended quitting medications are NRT gum, NRT patch, NRT nasal spray, NRT inhaler, NRT lozenge, Varenicline (Chantix) and Bupropion (Zyban).

Fiore MC, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: US Department of Health and Human Services. Public Health Service: May 2008.

1. CDC, Behavioral Risk Factor Surveillance System, 2020.

2. CDC, Youth Risk Behavioral Surveillance System, 2019.

3. CDC, Behavioral Risk Factor Surveillance System, State Tobacco Activities Tracking and Evaluation System, 2021.

4. Campaign for Tobacco-Free Kids, Broken Promises to Our Children: a State-by-State Look at the 1998 State Tobacco Settlement 22 Years Later FY2021, 2020.

5. Campaign for Tobacco-Free Kids, Toll of Tobacco in the United States.

6. American Lung Association, State Legislated Actions on Tobacco Issues (SLATI).

7. American Lung Association, State of Tobacco Control, 2021.

8. Campaign for Tobacco-Free Kids. State Cigarette Excise Tax Rates & Rankings. https://www.tobaccofreekids.org/assets/factsheets/0097.pdf. Accessed.

9. Public Health Law Center. U.S. E-Cigarette Regulation: 50-State Review. http://www.publichealthlawcenter.org/resources/us-e-cigarette-regulations-50-state-review. Accessed.