Fewer people in South Carolina are smoking every year, but a report the American Lung Association released Wednesday, Jan. 28, 2026, said the state could do more to reduce usage amid federal cuts. (Photo by Douglas Sacha/Getty Images)
COLUMBIA — The number of smokers in South Carolina has dropped in recent years, but the state could do more to discourage people from puffing away, according to a report from the American Lung Association released Wednesday.
With federal cuts to nationwide smoking deterrent programs, the lung health association warned that hard-won decreases in the number of adults and teenagers who smoke could backslide unless states step in to make up the difference.
“Last year was a devastating year for tobacco prevention and control policies,” said Danna Thompson, who oversees the association’s policy pushes for a handful of Southeastern states, including South Carolina.
“It’s really on the state to take action to prevent and reduce tobacco use,” Thompson said.
An estimated 12% of South Carolinians smoked as of 2023, according to the most recent data available from the state health department. More than three decades prior, in 1992, that number was 27%, according to historical data from the Centers for Disease Control and Prevention.
A much bigger decrease came from teenagers who smoke. In 2021, a quarter of high school students surveyed reported using any sort of nicotine product, with electronic cigarettes, or vapes, being the clear favorite: 21% used e-cigarettes regularly, compared to 3% who smoked tobacco cigarettes, according to the state health department.
That dropped to 10% of students in 2024, the most recent data available, with 9% saying they smoked e-cigarettes.
Federal and statewide initiatives contributed to those drops, Thompson said.
But federal budget cuts last year gutted the Office on Smoking and Health, which ran anti-smoking ads, promoted hotlines to help people looking to quit and created resources on the harms of smoking. Unless Congress restores the office’s staff and funding, states will likely have to make up the difference in resources and funding from the office, Thompson said.
Otherwise, that would mean an annual loss of $1.7 million for South Carolina’s efforts. Nationwide, states received $85 million total for the 2024 fiscal year, according to the CDC.
“These actions weaken enforcement,” Thompson said. “It risks reversing years of declining tobacco use and really has hindered many state and local efforts.”
South Carolina’s health agency has nearly $7 million to spend on reducing tobacco use and vaping this fiscal year, which ends June 30, the report found. That goes toward resources to support people trying to quit smoking, including a 24/7 helpline, one-on-one coaching and free non-prescription medications, such as nicotine gum, through the state’s Tobacco Quitline.
The association wants an additional $5 million, doubling the amount the state typically spends to reduce smoking. State spending increased in recent years with an influx of cash from a settlement with e-cigarette company Juul, which is required to pay the state just over $11 million by the end of 2031, at the latest.
The suggested $5 million would more than offset a loss of federal funding, Thompson said.
“We know that making these investments in tobacco prevention and control is a proven way to reduce people starting to use tobacco and nicotine products and as a means to help them quit,” Thompson said.
More than 13,300 people called the hotline in 2024, the most recent year of data available, according to the North America Quitline Consortium, which oversees similar hotlines for every state. Nearly 6,600 South Carolinians received services through the program that year.
That program is “amazing” in getting smokers treatment, said Beth Johnson, a lobbyist for the South Carolina Cancer Action Center.
“If you talk to most smokers, they want to quit tobacco,” Johnson said. “But they sometimes need a little extra help because, of course, we’re looking at nicotine, which is a very addictive drug.”
The state also offers resources, including for schools, meant to educate people on the harms of smoking. Like in the country as a whole, smoking is the leading cause of preventable death and disease in South Carolina, according to the report. Smokers are at a heightened risk of lung cancer, heart disease, strokes and diseases that cause breathing trouble.
Telling people about the risks of smoking and vaping is one goal of Smokefree SC, a Columbia-based nonprofit that supports anti-smoking organizations across the state.
In years past, the organization received just under $700,000 from the state health department to fund educational talks in schools, called “vape talks,” as well as grants to smaller local nonprofits and training sessions for adults, said Barbara Derrick, Smokefree SC’s executive director.
The state contract ended in the fall of 2025, amid the federal cuts to tobacco reduction programs, she said. Since then, the nonprofit has kept up its work using what’s left over of a $1 million earmark it received two years ago, she said.
More money would mean more “vape talks” for students, parents and teachers, Derrick said. Last year, the nonprofit’s two community outreach workers did 40 total talks that reached nearly 4,000 people.
“It’s a constant battle to counteract (vaping), and it’s one that we still fight,” Derrick said.
The CDC recommends South Carolina spend $51 million based on its population and the number of smokers it has, according to the report. Only one state, Maine, matches the CDC’s funding recommendation, which certainly won’t make it into South Carolina’s budget.
To keep people from accessing cigarettes and other tobacco products, the report recommends the state increase its tobacco tax.
Thompson also advocates for taxing e-cigarettes the same as tobacco cigarettes. Though e-cigarettes (or vapes) have nicotine, they don’t have tobacco, so they aren’t taxed like regular cigarettes, as defined by state law. There are no specific taxes on vapes in South Carolina.
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Compare that to cigarette taxes.
And South Carolina still has one of the nation’s lowest, at 57 cents per pack of 20 cigarettes. Only four states have lower cigarette taxes, including neighboring Georgia and North Carolina, other major tobacco-growing states historically.
Nationwide, the average state tax on cigarettes is $2.05 per pack. The federal cigarette tax adds $1.01 per pack, according to the Campaign for Tobacco-Free Kids.
South Carolina’s tax on other tobacco products — including cigarillos, chewing tobacco, snuff, and tobacco for pipe smoking — is 5% of the manufacturers’ price, unchanged since 1996.
During the last fiscal year, taxes on all tobacco products brought in nearly $114 million, according to the state Revenue and Fiscal Affairs Office.
When legislators passed the cigarette tax increase, they also designated where the money could go, spending $5 million annually to prevent and reduce smoking, $5 million for cancer research and the rest on Medicaid costs.
In a state focused on cutting taxes, increasing one seems highly unlikely.
The cigarette tax hasn’t increased since that 2010 law, when legislators overrode a veto from then-Gov. Mark Sanford to raise the tax by 50 cents. And that was the first increase in cigarette taxes in 33 years.
But Thompson says making cigarettes more expensive is an effective way to get cigarettes out of the hands of teenagers and people in poor, rural areas, who are often more likely to smoke.
Raising taxes on cigarettes and vapes would be more effective than creating a registry of e-cigarettes, as a bill working its way through the Legislature would, she added.
Proposed as a way of getting vapes out of the hands of children and teens, a Senate bill the House passed last week would form a list of products with approval or pending approval from the Food and Drug Administration that stores in the state could sell.
The idea is to standardize what the state can or can’t sell in an effort to crack down on sales of illegal fruit- and candy-flavored e-cigarettes popular among students, legislators have said.
The American Lung Association contends the bill will not actually help quell vaping among school children and state resources are better spent on other prevention efforts.
“It is not moving the needle,” Thompson said.
After the House’s vote of 66-33 to pass the bill, it went back to the Senate, which can agree to changes the House made or send the bill to a conference committee, where the two chambers hammer out their differences.
