The American Lung Association has given both Kentucky and Ohio a flunking grade when examining state funding for tobacco prevention and cessation funding.
It marks the ninth straight year both states have been marked as failing at funding tobacco control programs and providing resources to help tobacco consumers quit.
For 2025, the American Lung Association gave Ohio an extra thumbs down.
"Thumbs down for Ohio for decreasing state funding for its tobacco control program by over $7 million each of the last two fiscal years," the report from the American Lung Association reads.
In a 2022 Ohio Department of Health study looking into tobacco use by adults in the state, the agency acknowledged that cigarette smoking prevalence among adults "decreased significantly from 2013 (23.4%) to 2022 (17.1%) but remains well above the national prevalence."
In addition, that study also notes that e-cigarette use among adults in Ohio has significantly increased in recent years. E-cigarette use by adults in Ohio has increased from 4.6% in 2015 to 8.8% in 2022.
In all, the ALA's website says it "calls for the following actions to be taken" by elected officials in Ohio to reduce tobacco use. The organization wants Ohio to increase its cigarette tax by $1.50 per pack and establish tax parity across all tobacco products. Currently, Ohio's tax on a pack of 20 cigarettes is $1.60.
The ALA also wants Ohio to defend its smokefree workplace law from rollbacks or added exemptions. It also wants funding for tobacco prevention and cessation programs to be closer to the CDC's recommendations for Ohio.
In 2014, the CDC issued a best practices guide for states. That guide suggested Ohio invest $132 million annually in smoking intervention initiatives. That report cited the state's annual costs from smoking were $5.647 billion.
For 2025, Ohio is currently slated to spend just over $10 million in total funding for state tobacco control programs — around 7.8% of the CDC's recommendation. That funding is comprised of $7.78 million allocated by Ohio itself for the program, and just under $2.5 million from federal sources like the CDC.
The CDC considers tobacco use the leading preventable cause of disease and death in the country.
By comparison, Kentucky received a thumbs up for increasing its funding for its state tobacco control program by nearly $2 million in 2025. The non-profit still gave the Commonwealth an F grade in the category overall.
The CDC's recommendations for Kentucky issued in 2014 say the Commonwealth should be spending $56.4 million annually on smoking cessation programs.
For 2025, Kentucky is slated to spend $6.4 million — around 11% of the CDC's recommended level. That's a combination of $4.7 million allocated by the state and roughly $1.66 million provided from federal sources, like the CDC.
The ALA is calling for Kentucky to "require all establishments selling nicotine products to obtain licenses, provide for and fund specific enforcement measures and establish a meaningful penalty structure for underage sales violations."
It also wants the state to increase funding for smoking prevention and cessation programs to $4 million — which Kentucky has done for 2025. However, the ALA also wants Kentucky to allocate a Juul settlement funds program and ensure the funding is spent according to CDC best practices.
Finally, the ALA wants Kentucky to support and defend local comprehensive smokefree laws, including provisions around e-cigarettes.
Like Ohio, the ALA ranked Kentucky's tobacco taxes as an F — but unlike Ohio, the organization did not issue any recommendations for what that tax should be. Kentucky's tax on a pack of 20 cigarettes is currently $1.10.
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