Kentucky is not doing enough to prevent smoking and vaping, says annual report

By Sarah Ladd
Kentucky Lantern

The American Lung Association gave Kentucky mostly failing grades when it comes to preventing tobacco use — and helping people access recovery — in a 2025 report released Wednesday.

The new “State of Tobacco Control” report “evaluates state and federal policies on actions taken to eliminate use and recommends proven-effective control laws and policies to save lives.”

It says Kentucky lawmakers should require merchants who sell nicotine products to have licenses to do so.

This is at least partially in line with what Lebanon Republican Sen. Jimmy Higdon wants to do during the 2025 legislative session. Higdon told a committee in November that he would file legislation to license all sellers of tobacco or vape products, giving the Department of Alcoholic Beverage Control (ABC) the same enforcement authority over businesses that sell nicotine products as those that sell alcohol, including the power to enter the businesses without warrants.

He has yet to file the bill, but still intends to, according to a Senate Republican spokesman. The legislature is on break but returns to Frankfort Feb. 4 to finish the 2025 session.

The lung association also wants Kentucky to “provide for and fund specific enforcement measures and establish a meaningful penalty structure for underage sales violations.”

Shannon Baker, the advocacy director at the American Lung Association in Kentucky, said in a statement that “policymakers in Kentucky must focus on requiring retail licenses to sell nicotine products and increasing funding for youth quit-smoking programs” this year.

“In addition to grading Kentucky’s policies, this year’s ‘State of Tobacco Control’ report examines the industry’s increasingly aggressive actions to addict a new generation to nicotine and hinder proven public policies to prevent and reduce use,” Baker said in a statement.

“Here in Kentucky, we are seeing industry lobbyists at the state and local levels working to stop or weaken proven nicotine control policies,” she said. “The industry is also introducing new products that appeal to youth like e-cigarettes that mimic smartphones, kid-friendly flavors and flavored nicotine pouches that are heavily marketed by social media influencers.”

Tobacco use takes an especially high toll in Kentucky, where smoking and lung cancer rates exceed those in the rest of the nation.

About 17% of Kentucky adults smoke vs. 11% nationally. In Kentucky, 5% of high school students smoke and almost 20% use e-cigarettes, according to The Campaign for Tobacco-Free Kids. Smoking costs the state more than $2 billion every year in health complications, according to the campaign.

Smoking is also a leading cause of preventable death across the country, according to the Association of American Medical Colleges.

What do these grades mean? 

Michael Seilback, the assistant vice president of state public policy for the American Lung Association, said the poor grades are due in large part to Kentucky not spending enough on cessation and prevention. The report card puts the state toward the bottom in the country, he told the Lantern.

“Kentucky received grades that by no account would be a report card that anybody would want to bring home,” Seilback said.

The State of Tobacco report gives Kentucky these “grades”:

• Funding for State Tobacco Prevention Programs — F. This grade is because Kentucky spends only a small portion of what it should on tobacco control, Seilback said. Overall, it spends about $50 million less than what it needs to, he said.
• Strength of Smoke-Free Workplace Laws — F. The lung association wants to see comprehensive protections in place that guarantee no one will be exposed to secondhand smoke in their place of employment, Seilback said. He believes a 2025 House Bill could undermine this by overriding local control. This bill says local ordinances restricting smoking will not apply to the interior of cigar bars.
• Level of State Tobacco Taxes — F. Kentucky’s tax rate for a 20-pack of cigarettes is $1.10, which Seilback said is much lower than other states (some charge $5) and the national average. Increasing this could deter consumption, he said
• Coverage and Access to Services to Quit Tobacco — C. Kentucky offers “comprehensive coverage for cessation medication and counseling” through Medicaid, Seilback said, “which is really important.” Hurting Kentucky’s grade here is the amount of money the state spends per smoker: 98 cents.
• Ending the Sale of All Flavored Tobacco Products — F. Kentucky hasn’t done enough to limit flavored tobacco products, Seilback said, which “attract younger people” and “mask the harshness of the chemicals and toxins that are in these products.”

What has Kentucky done, and where does it go from here?

In 2024, the state legislature passed a law aimed at curbing underage vaping by limiting sales to “authorized products” or those that have “a safe harbor certification” based on their status with the Food and Drug Administration (FDA).

The bill was backed by Altria, the country’s largest manufacturer of cigarettes which also markets FDA-approved vape products. Altria has spent more than $500,000 lobbying the Kentucky legislature since January 2022, according to records filed with the Legislative Ethics Commission.

The American Lung Association’s stance is that this law “was a missed opportunity, a failed opportunity,” Seilback said.

“We don’t believe that it’s going to have the effect that others might have,” he added.

The law faced an unsuccessful constitutional challenge that argued it was too broad and arbitrary. It went into effect Jan. 1. Some have argued it does little more than harm businesses while others say it didn’t go far enough to stop youth from accessing the products.

The argument that crackdowns on tobacco sales are anti-business isn’t unique to Kentucky, Seilback said. In fact, “there’s probably not a state we don’t hear that argument.”

But, he said, “there is a cost to Kentucky because of tobacco use.”

“It’s important to remember that the cost of addiction and the cost of tobacco to our state is significant,” he said. “There’s health care costs, there’s lost days of work. And so we shouldn’t think about these things in such a black-and-white way because the costs are tremendous. And, in states and localities that have regulated tobacco products, we have not seen the economic harm that is often presented by opponents to these laws.”