North Dakota Highlights

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Tobacco use remains the leading cause of preventable death and disease in the United States and in North Dakota. To address this enormous toll, the American Lung Association calls for the following actions to be taken by North Dakota’s elected officials:

  1. Raise the state tobacco tax currently at .44 per pack;
  2. Tax electronic delivery devices; and
  3. Keep the Indoor Smoke Free Air Law strong.
In 2024, North Dakota was in the middle of their legislative biennium, with no convening of the legislature until 2025. North Dakota is ranked at 49th in the U.S. for its tobacco tax of 44 cents per pack. The tax has not been raised since 1993 leaving prices of commercial tobacco products in the state dangerously low. Funding for the state’s tobacco prevention and control program in the North Dakota Department of Health remains the same as last year under the two-year state budget passed in 2023.

At the local level, the Valley City Council placed an advisory question on the June 2024 city-wide election ballot in an effort to overturn the 2016 ordinance that restricted the sale of all flavored vape products. The American Lung Association, along with local advocates and state and national partners, worked to defeat this effort. As a result, an overwhelming 68% of voters chose to keep the existing restrictions in place, protecting the health of their community.

The American Lung Association will continue its work in 2025 to educate both state and local decision makers about the benefits of a higher tobacco tax on all tobacco products, including electronic delivery devices and to keep the state Clean Indoor Air Law strong.

North Dakota Facts
Healthcare Costs Due to Smoking: $325,798,988
Adult Smoking Rate: 13.30%
Adult Tobacco Use Rate: 23.80%
High School Smoking Rate: 5.90%
High School Tobacco Use Rate: 23.00%
Middle School Smoking Rate: N/A
Smoking Attributable Deaths per Year: 980
Adult smoking and tobacco use data come from CDC’s 2023 Behavioral Risk Factor Surveillance System; adult tobacco use includes cigarettes, smokeless tobacco and e-cigarettes. High school smoking and tobacco use rates are taken from the 2021 Youth Risk Behavior Surveillance System. A current middle school smoking rate is not available for this state.

Health impact information is taken from the Smoking-Attributable Mortality, Morbidity and Economic Costs (SAMMEC) software. Smoking-attributable deaths reflect average annual estimates for the period 2005-2009 and are calculated for persons aged 35 years and older. Smoking-attributable healthcare expenditures are based on 2004 smoking-attributable fractions and 2009 personal healthcare expenditure data. Deaths and expenditures should not be compared by state.

North Dakota Information

Learn more about your state specific legislation regarding efforts towards effective Tobacco Control.

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