South Dakota Highlights

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

  1. Increase the tax on cigarettes and other commercial tobacco products, including e-cigarettes;
  2. Fully fund South Dakota's tobacco control program; and
  3. Amend the state law that prevents the state Medicaid program from covering all tobacco cessation medications.
During the 2024 legislative session, funding for the states tobacco control program was set at $4.5 million from tobacco tax revenues, the same level as the past few years. Protecting this funding is important to be able to serve the priority populations in the state strategic plan and to fund quit smoking services.

Medicaid coverage of quit smoking treatments in South Dakota is also far from comprehensive, and one of the main reasons is a state law that prevents the state Medicaid program from buying nicotine. Unfortunately, without an exception this has the unintended consequence of preventing the state from buying FDA-approved nicotine replacement therapy (NRT). The Lung Association encourages legislators to address this issue in 2025 by creating an exception for FDA-approved tobacco cessation medications, so Medicaid enrollees who smoke at higher rates can gain access to a fuller range of quit smoking treatment options.

During the past year, the South Dakota Tobacco Control Program has been working on finding new ways to connect with people in South Dakota who use tobacco and get them to the South Dakota Quitline, as well as preventing young people from ever starting to use tobacco products.

The coalition in South Dakota has tremendous reach across the state and is working together to support tobacco control best practices and to implement the strategic plan to reduce the harm from commercial tobacco in South Dakota in 2025. With your help, tobacco control advocates, including the American Lung Association will ensure that our leaders pay attention to lung health as we advocate for action to pass laws and put in place programs that will save lives.

South Dakota Facts
Healthcare Costs Due to Smoking: $373,112,273
Adult Smoking Rate: 15.20%
Adult Tobacco Use Rate: 23.40%
High School Smoking Rate: 5.50%
High School Tobacco Use Rate: 16.50%
Middle School Smoking Rate: 2.00%
Smoking Attributable Deaths per Year: 1,250
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 data come from the 2021 Youth Risk Behavior Surveillance System. Middle school smoking rate is taken from the 2017 Youth Tobacco Survey.

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.

South Dakota Information

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

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