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  4. Federal Priorities for the 118th Congress: Tobacco

Federal Priorities for the 119th Congress: Tobacco

Here are key actions the Centers for Disease Control and Prevention, the Food and Drug Administration, the Centers for Medicare and Medicaid Services, U.S. Congress and other federal leaders must take to preserve the Tobacco Control Act, prevent commercial tobacco* use, help all commercial tobacco users get the help they need to end their addiction and to prevent chronic diseases.

*Tobacco products refer to commercial tobacco products and not the traditional practices and use of tobacco practiced in many Indigenous communities.

Increase Federal Investments in Tobacco Prevention and Help Tobacco Users Quit

Tobacco use remains the leading cause of preventable death and disease, and 2.25 million kids still use tobacco products in this country. The federal government needs to increase its investment in efforts to prevent future addiction and help current users quit.

The CDC Office on Smoking and Health (OSH) must receive robust funding to help combat the tobacco-caused diseases that are burdening the nation. Public health interventions supported by CDC OSH, such as the funding provided to state tobacco control programs and “Tips from Former Smokers” media campaign, are proven to reduce tobacco use. Congress should appropriate $310 million to OSH.

The “Tips From Former Smokers” campaign is a highly effective media campaign that features stories of people living with smoking-related diseases, but limited funding permits it to air less than half the year. From 2012-2018, “Tips” resulted in over 1 million people quitting, saved an estimated 129,000 lives and prevented $7.3 billion in smoking healthcare costs. Congress should increase funding for CDC OSH so that “Tips” can air year-round.

The Food and Drug Administration should continue its investments in “The Real Cost” campaign, a youth prevention mass media campaign which is proven effective at reducing youth tobacco use.  “The Real Cost” campaign is a proven cost-effective campaign that prevents youth use of cigarettes, smokeless tobacco products and e-cigarettes.

  • Unlike all other tobacco product manufacturers, e-cigarette manufacturers currently do not pay user fees to FDA. Congress must pass the Resources to Prevent Youth Vaping Act, bipartisan legislation that would require e-cigarette manufacturers to pay user fees to the FDA, aligning them with fees already paid by other tobacco product manufacturers. These fees would fund efforts to combat youth vaping, including enforcement actions against illegal products. 

Strengthen Restrictions on the Manufacture, Sale and Marketing of Tobacco Products

Tobacco products are the deadliest consumer products on the market today, ultimately killing up to half of its users.  The Administration and Congress must take steps to protect and preserve the Tobacco Control Act to restrict the manufacture, sales and marketing of tobacco products.

  • Since 2009, FDA has failed to use the comprehensive authority it has from the Tobacco Control Act to put meaningful restrictions on tobacco products, including e-cigarettes, products with synthetic nicotine and nicotine pouches, in place. New tobacco products, including all e-cigarettes, products containing synthetic nicotine, and nicotine pouches are required to submit a pre-market tobacco product application to FDA prior to coming onto the market to determine whether they should be authorized to be sold. FDA must follow the law in reviewing these applications and require the removal of all tobacco products that failed to file an application, products that have received marketing denial orders and products that are awaiting FDA’s decision. FDA and the Department of Justice must continue to defend FDA’s pre-market tobacco authority in the Triton Distribution v. FDA case before the U.S. Supreme Court and other cases challenging FDA marketing denial orders. 
  • products to below levels that sustain addiction will make it easier for smokers to quit and harder for youth to become addicted. FDA must not limit its focus solely to cigarettes; FDA must propose and finalize regulations to reduce nicotine levels in all tobacco products, including cigars, smokeless tobacco and e-cigarettes.
  • The 2009 Tobacco Control Act requires FDA to issue a rule requiring all cigarette packs have graphic warning labels on the 50% of the front and back of all cigarette packs. A 2020 ruling in a federal lawsuit brought by the American Lung Association and public health partners resulted in FDA releasing final graphic warnings by March 15, 2020. Tobacco industry lawsuits have delayed this requirement. The Supreme Court has declined to hear an appeal of a 5th Circuit Court of Appeals decision that upheld the graphic warning labels on constitutional grounds, affirming the decision. The case now returns to the District Court to examine and resolve other issues raised by the tobacco company plaintiffs. The rule is currently in effect, but FDA is deferring enforcement until December 2025 pending final court action. FDA and the Department of Justice must continue to strongly defend graphic warning labels in the federal courts until all lawsuits are resolved and the rule is implemented.
  • The 2009 Tobacco Control Act calls for the FDA to create a comprehensive track and trace system to counter the threat of illicit markets and maximize the public health benefits of strong oversight, which the agency has failed to do thus far. The tobacco industry has a history of being complicit in supplying illicit markets, repeatedly opposing taxation proposals to protect public health and financially benefitting from the illicit diversion of their own products. FDA must propose and finalize regulations in 2025 to implement “track and trace” technology on all tobacco products to prevent an illicit market, counterfeit and smuggling activities.
  • The 2009 Tobacco Control Act required FDA to issue two regulations regarding the sale and distribution and then the promotion and marketing of tobacco products through means other than a direct, face-to-face exchange between a retailer and a consumer also known as remote sales. These rules were supposed to be issued by December 22, 2010 and June 22, 2011 respectively.  FDA took no action on remote sales during that timeframe and has yet to issue any rules to date. FDA must propose and finalize rules on remote sales and should completely prohibit such sales.

Help People End Their Addiction

Quitting smoking is the single best thing a person who smokes can do for their health. As more people quit smoking, the financial burden for the healthcare system and society at large is also decreasing. Congress, the Administration and states can take important steps to help tobacco users end their addiction.

  • Standard, or traditional, Medicaid is required to cover all tobacco cessation medications, however there is no requirement for counseling coverage for non-pregnant adults. State Medicaid programs may impose barriers on the non-pregnant standard Medicaid population. Congress should pass legislation to expand coverage to a comprehensive tobacco cessation benefit for all traditional Medicaid plans.
  • Millions of people have access to preventive services – including tobacco cessation – at no cost due to the Patient Protection and Affordable Care Act (ACA). However, this coverage is at risk due to the Braidwood lawsuit. Congress and the Administration must ensure that individuals continue to receive lifesaving preventive services without cost-sharing.
  • Beyond counseling, there is very little research on what is effective in helping youth quit tobacco products. Federal research investments by NIH investigating youth cessation interventions, including pharmacotherapies, must be prioritized.
  • 2006 was the last time a new tobacco cessation medication was found to be safe and effective by the FDA. FDA must prioritize taking steps to improve the regulatory process to approve cessation medications to help people end their addictions. 

Increase and Equalize Tobacco Taxes

Increasing the price of tobacco products is one of the most effective ways to reduce tobacco use, especially among youth. Every 10% increase in the price of cigarettes reduces consumption by 4% among adults and 7% among kids.

  • The federal government has not increased taxes on cigarettes and other tobacco products since 2009 and a significant increase is long overdue. Increasing tobacco taxes is one of the most important actions Congress could take to reduce youth initiation and incentivize tobacco users to quit for good. Congress should pass legislation that would double the federal tax rate on cigarettes and equalize the federal tax rate for all other tobacco products.

Page last updated: December 19, 2024

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