Fact Sheet

Tobacco use: North Dakota 2026

Topic

Smoking by Region

Subtopic

State Facts

Cigarette use: North Dakota*

In 2024, 12.4% of adults smoked. Nationally, the adult cigarette smoking prevalence was 11.6%.
In 2018-2019, 21.8% of adults who smoked in North Dakota smoked menthol cigarettes. Nationally, 32.3% of adult smokers used menthol cigarettes during this period.
In 2023, 5.4% of high school students in North Dakota smoked cigarettes on at least one day in the past 30 days. Nationally, the cigarette smoking prevalence among high school students was 3.5%.

Other tobacco product use: North Dakota 2026*

In 2024, 9.3% of adults in North Dakota used e-cigarettes. Nationally, the adult e-cigarette use prevalence was 8.0%.
In 2024, 5.5% of adults in North Dakota used smokeless tobacco every day or some days. Nationally, the adult smokeless tobacco use prevalence was 2.0%.
In 2023, 18.2% of high school students in North Dakota used electronic vapor products on at least one day in the past 30 days. Nationally, the e-cigarette use prevalence among high school students was 18.0%.
In 2023, 3.4% of high school students in North Dakota used chewing tobacco, snuff, or dip on at least one day in the past 30 days. Nationally, the smokeless tobacco use prevalence among high school students was 2.3%.
In 2023, 4.2% of high school students in North Dakota smoked cigars, cigarillos, or little cigars on at least one day in the past 30 days. Nationally, the cigar use prevalence among high school students was 4.5%.

Economics of tobacco use and control

North Dakota received $41.2 million (estimated) in tobacco revenue in fiscal year 2026.
Of this, the state allocated $5.9 million in state funds to tobacco prevention in fiscal year 2026, representing 60.3% of the Centers for Disease Control and Prevention's annual spending target.
Smoking-caused health care costs: $379 million per year.
Smoking-caused losses in productivity: $715 million per year.

North Dakota tobacco laws

Tobacco taxes

North Dakota is ranked 49th in the U.S. for its cigarette tax of 44 cents per pack (enacted July 1993), compared to the national average of $2.01. New York has the highest tax at $5.35, and Missouri has the lowest at 17 cents.
Cigars and pipe tobacco are taxed at 28% of the wholesale price, chewing tobacco is taxed at 16 cents per ounce, and snuff is taxed at 60 cents per ounce.

Clean indoor air ordinances

Smoking is prohibited in government workplaces, private workplaces, schools, childcare facilities, restaurants, bars, casinos and gaming establishments (tribal establishments are exempt), retail stores, and within 20 feet of entrances, exits, windows, air intakes, and ventilation systems in public places and places of employment.
E-cigarettes are included in the state's indoor air laws and in the state's definition of smoking but are not included in the state's definition of tobacco products.

Licensing laws

Retailers and wholesalers are required to obtain a license to sell tobacco products.
A license is required to sell e-cigarette products (effective Aug. 1, 2023).

Preemption

North Dakota does not allow local governments to enact tougher regulations than the state level, citing the home rule charter.

Youth access laws

In December 2019, the United States adopted a law raising the federal minimum age of sale for all tobacco products to 21, effective immediately.
People under 21 are prohibited from buying e-liquid and/or e-cigarettes.
Self-service displays of electronic smoking devices are restricted to tobacco specialty stores and vending machines that are inaccessible to persons under 21 or controlled by the seller.
Retail sales and shipment of electronic smoking devices through the mail are prohibited unless the retailer verifies that the purchaser is at least 21 years of age and requires the signature of a person at least 21 years of age upon delivery.

Local tobacco laws

Cando prohibits the sale of flavored tobacco products, except menthol cigarettes, cigars, and smokeless tobacco.
Valley City prohibits the sale of flavored e-cigarettes.

Quitting statistics and benefits

The CDC estimates that 50.7% of daily adult smokers in North Dakota quit smoking for one or more days in 2019.
In 2014, the Affordable Care Act required Medicaid programs to cover all tobacco cessation medications.
North Dakota's state quitline invests $11.71 per smoker, compared to the national median of $2.62.
North Dakota has a private insurance mandate provision for tobacco cessation.

Notes and references (March 2026)

The datasets for both adult and youth prevalence were used to make direct comparisons at the state and national levels. National prevalence reported here may differ from what is reported in national fact sheets. The numbers here also reflect the most recent data available. Dates of available data may differ across state fact sheets.

The seven recommended cessation medications are nicotine gum, nicotine patch, nicotine nasal spray, nicotine inhaler, nicotine lozenge, varenicline (Chantix), and bupropion (Zyban).

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

Sources

CDC. (2024). Behavioral Risk Factor Surveillance System.
CDC. (2024). State Menthol Fact Sheets.
CDC. (2023). High School Youth Risk Behavior Surveillance System.
Campaign for Tobacco-Free Kids. (2026). Broken Promises to Our Children: A State-by-State Look at the Tobacco Settlement and State Tobacco Revenues.
Campaign for Tobacco-Free Kids. (2024). The Toll of Tobacco in the United States.
American Lung Association. (2026). State Legislated Actions on Tobacco Issues (SLATI).
American Lung Association. (2026). State of Tobacco Control.
Campaign for Tobacco-Free Kids. (2024). State Cigarette Excise Tax Rates & Rankings.
Public Health Law Center. (2024). U.S. E-Cigarette Regulations: 50-State Review.
North Dakota Legislative Assembly. House Bill 1307. Relating to Supersession of State Laws in Home Rule Counties and Cities.
Truth Initiative. (2024). Local Restrictions on Flavored Tobacco and E-Cigarette Products.
CDC. (2024). Behavioral Risk Factor Surveillance System, State Tobacco Activities Tracking and Evaluation System.