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North Dakota

US ND
The Toll of Tobacco in North Dakota
High school students who smoke (2025) 6.1% (2,700)
High school students who use e-cigarettes (2025) 14.8%
Male high school students who smoke cigars (female use much lower) (2025) 5.6%
Kids (under 18) who try cigarettes for the first time each year 1,100
Adults in North Dakota who smoke (2025) 12.4% (76,400)
Deaths in North Dakota from Smoking
Adults who die each year from their own smoking 1,000
Proportion of cancer deaths in North Dakota attributable to smoking 28.3%
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 the state directly caused by smoking $379 million
Portion covered by the state Medicaid program $61.1 million
Residents' state & federal tax burden from smoking-caused government expenditures $887 per household
Smoking-caused productivity losses in state $715.0 million
Amounts do not include health costs caused by exposure to secondhand smoke, smoking-caused fires, or use of non-cigarette tobacco products. Productivity losses are from smoking-caused premature death and illness that prevent people from working. Tobacco use also imposes costs such as damage to property.
Tobacco Industry Influence in North Dakota
Annual tobacco industry marketing expenditures nationwide $10.5 billion
Estimated portion spent for this state 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.

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Last updated Oct. 13, 2026