Cigarette smoking rates and lung cancer deaths have declined in New Jersey over the past two decades and these rates remain lower than the nation at large. But policy experts say the tobacco industry continues to block changes — on the state and federal levels — that would make for cleaner air and healthier communities, particularly for people of color.

The American Lung Association’s 2025 State of Tobacco Control report, released Wednesday, urged state lawmakers to end the portion of the state’s 2005 Smoke-Free Air Act that allows people to smoke inside New Jersey casinos. The annual report also called on state leaders to ban menthol cigarettes, increase tobacco taxes and invest more in anti-smoking initiatives.

“Here in New Jersey, we are seeing tobacco industry lobbyists working to prevent smokefree casinos from becoming a reality. The tobacco industry is also introducing new products that appeal to youth like e-cigarettes that mimic smartphones, kid-friendly flavors and flavored nicotine pouches that are heavily marketed by social media influencers,” said Michael Seilback, assistant vice president for nationwide advocacy at the American Lung Association, in a press release.

Nearly 12,000 people die each year in New Jersey from tobacco use, according to the Lung Association. Nationwide, smoking remains a leading cause of death — and the top cause of preventable death, experts note — resulting in some 490,000 fatalities annually in the U.S., according to the 2024 report from the U.S. Surgeon General, an annual report first published 50 years ago.

The Lung Association’s report comes days after the Trump administration announced it would not seek to ban menthol tobacco products on a federal level, something former President Joe Biden’s team had tried unsuccessfully to do through regulation. Menthol cigarettes are particularly popular in Black, LGBTQ+ and other historically marginalized communities, according to the Lung Association, with 8 in 10 Black smokers choosing a menthol-flavored brand.

NJ gets D grade for menthol measures

New Jersey banned the sale of flavored vape products in 2019 and one study shows use of electronic cigarettes, or e-cigarettes, has declined among teenagers. But efforts to include menthol cigarettes in that law failed and lawmakers — led by former Assemblyman Herb Conaway (D-Burlington), who has since been elected to the House of Representatives — have yet to advance.

The Lung Association’s report assigns letter grades to states’ tobacco-control efforts in five different areas. It gave New Jersey a D for its work to end access to menthol and other flavored products. Only Massachusetts and the District of Columbia received A grades in this category; both have near total bans on flavored tobacco products and California got a B. No states received a C and New York got the only other D grade. All other states received an F.

Nationwide, the Lung Association noted a “troubling lack of progress on smokefree laws [that] mean millions of people are still exposed to the myriad of harms caused by secondhand smoke.” No states passed new broad smoking bans in 2024, it said, although Maryland expanded an existing restriction to include e-cigarettes. Efforts to close loopholes that permitted casino smoking failed in both New Jersey and Rhode Island, the report said.

The casino fight

Efforts to end smoking in New Jersey’s casinos have led to spirited hearings — with some protesters lighting up in the State House to prove how disruptive smoking can be in the workplace — and divided workers in Atlantic City. Currently, smoking is permitted on 25% of the casino floor but those areas are not always connected, and smoke can spread in the building. When legislation to close the loophole failed to advance, workers represented by the United Auto Workers filed a lawsuit in April that claimed they were denied equal protection under the state’s indoor smoking ban.

“We’re fighting for the right to breathe clean air,” Borgata dealer Pete Naccarelli, co-founder of Casino Employees Against Smoking Effects, told NJ Spotlight News in December. Colleagues of his have suffered from asthma, emphysema and COPD (chronic obstructive pulmonary disease), he said.

Casinos banded together to fight the case, which they have said would drive away business and could force them to close facilities in New Jersey. Both sides produced data they say makes their case. A judge sided with casino owners’ argument in the fall and the UAW has since appealed.

Not all workers support the push to end smoking, however. “We are protecting our members against multiple casino closures and job losses,” Unite Here Local 54 president Donna DeCaprio told NJ Spotlight News in a statement in December.

The Lung Association made clear New Jersey’s casino smoking exemption needs to be closed if the state’s Smoke-Free Air Act is to be truly comprehensive. It gave New Jersey a B — the highest grade the state received in any category — for its relatively strong clean-air law, which prohibits smoking in almost all indoor and many outdoor areas. A dozen states, including New York, and Washington, D.C., received A grades, while 12 others were assigned Fs. Rhode Island received a C and Pennsylvania earned a D. “The U.S. Surgeon General has concluded there is no safe level of exposure to secondhand smoke and the emissions from e-cigarettes are not safe,” the report notes.

F grade on cigarette taxes

New Jersey was assigned a C grade for its level of insurance coverage for tobacco cessation programs and was one of more than two dozen states to get an F for its level of taxes, along with Delaware and Pennsylvania. Nationwide, cigarette taxes range from 17 cents in Missouri to $5.35 in New York. New Jersey levies $2.70 per pack, not including sales tax, and received an F grade in this category in the Lung Association’s 2023 and 2024 reports.

When it comes to funding for smoking cessation programs — another category where New Jersey has historically received low grades — the report gave the state an F. States that received higher grades tend to supplement federal dollars with local money to expand initiatives that help people quit tobacco use.

The 2025 report also warned that the new data comes as the federal court system is faced with questions about the future of preventive care programs, like smoking cessation, currently covered through the federal Affordable Care Act, which guaranteed patients’ access to certain services through publicly funded and commercial insurance plans. President Donald Trump has taken steps to tighten spending around various health care programs that advocates worry will curb the impact of smoking cessation efforts.