Report Gives Arkansas ‘F’ Grades for Tobacco Prevention, Cessation Efforts

Arkansas receives “F” grades in three categories in a new report that grades states on their tobacco prevention and cessation efforts.

The American Lung Association’s 2024 State of Tobacco Control report gives Arkansas failing grades for efforts to increase tobacco and cessation funding, increase tobacco taxes, and limit the availability of flavored tobacco products.

What the Grades Mean

On tobacco prevention and cessation funding, the report cites total funding for Arkansas’s tobacco control programs in fiscal year 2023 at $12.1 million, including $11 million in state funding and $1.1 million in federal funding. The total represents only a third of what the Centers for Disease Control and Prevention recommends the state spend on tobacco control efforts ($36.7 million), hence the state’s failing grade on this measure.

Arkansas receives an “F” grade in the tobacco tax category in part for having a low cigarette tax — $1.15 per pack vs. the national average of $1.93 per pack. Also factoring into the state’s grade in this category is the fact that although Arkansas’s taxes on small cigars, smokeless tobacco, and pipe tobacco are comparable to its cigarette tax, its tax on large cigars is low compared to the cigarette tax.

On flavored tobacco products, the state receives a failing grade for lacking any state law or regulation to restrict the sale of flavored tobacco products.

The report also gives Arkansas a “C” grade for its efforts to restrict smoking. While the state has prohibited or restricted smoking across many settings, including government workplaces and private workplaces, smoking is still allowed in restaurants, bars, and casinos and gaming establishments in Arkansas that do not allow persons under 21 to enter.

Arkansas receives a “C” grade for access to cessation services, an improvement from last year’s “D” grade in this category. The cessation service category is graded based on coverage for cessation services under the state’s Medicaid program and the state employee health plan, as well as the state’s investment in its tobacco cessation hotline. Arkansas’s grade in this category improved because its investment increased from $1.65 per smoker in the 2023 report to $1.93 per smoker in the 2024 report.

Arkansas Medicaid covers all seven pharmacotherapy treatments for tobacco cessation and covers individual and phone counseling services, but the program does not cover group counseling and requires prior authorization for bupropion (a prescription medication recommended for smoking cessation). The state employee health plan covers three of the seven pharmacotherapy treatments.

Recommendations

The report includes specific actions that policymakers in Arkansas can take to further curtail tobacco use, including:

• Ensuring continued access to tobacco cessation services for all those who want to quit smoking, including comprehensive coverage for cessation services under Medicaid.
• Allocating state funding of $14.6 million for the Arkansas Department of Health’s Tobacco Prevention and Cessation program and ensuring the funds are spent according to the CDC’s Best Practices for Comprehensive Tobacco Control Programs.
• Repealing state preemption of local tobacco control authority.

Arkansas has some of the highest smoking rates in the country, with nearly 18.7% of adults reporting they were current smokers in 2022 and 17% of high schools students reporting they used electronic vapor nicotine products within the past 30 days in 2022.