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The Toll of Tobacco in North Dakota
High school students who smoke8.3% (3,100)
Male high school students who smoke cigars (female use much lower)7.4%
High school students who use e-cigarettes33.1%
Kids (under 18) who become new daily smokers each year200
Adults in North Dakota who smoke17.4% (101,800)
Proportion of cancer deaths in North Dakota attributable to smoking27.0%


U.S. National Data
High school smoking rate (2020):4.6%
Male high school students who smoke cigars (2020):5.4%
High school students who use e-cigarettes (2021):11.3%
Adult smoking rate (2019):14.0%


Deaths in North Dakota from Smoking
Adults who die each year from their own smoking1,000
Kids now under 18 and alive in North Dakota who will ultimately die prematurely from smoking14,000

Smoking kills more people than alcohol, AIDS, car crashes, illegal drugs, murders, and suicides combined — and thousands more die from other tobacco-related causes — such as fires caused by smoking (more than 1,000 deaths/year nationwide) and smokeless tobacco use.


Smoking-Caused Monetary Costs in North Dakota
Annual health care costs in North Dakota directly caused by smoking$326 million
Medicaid costs caused by smoking in North Dakota$56.9 million
Residents' state & federal tax burden from smoking-caused government expenditures$916 per household
Smoking-caused productivity losses in North Dakota$232.6 million

Amounts do not include health costs caused by exposure to secondhand smoke, smoking-caused fires, smokeless tobacco use, or cigar and pipe smoking. Tobacco use also imposes additional costs such as workplace productivity losses and damage to property.


Tobacco Industry Influence in North Dakota
Annual tobacco industry marketing expenditures nationwide$8.4 billion
Estimated portion spent for North Dakota marketing each year$33.4 million

Published research studies have found that kids are twice as sensitive to tobacco advertising as adults and are more likely to be influenced to smoke by cigarette marketing than by peer pressure. One-third of underage experimentation with smoking is attributable to tobacco company advertising.

View sources of information.

More detailed fact sheets on tobacco's toll in each state are available by emailing

Last updated Jan. 21, 2022