Twelve states belong to what researchers call Tobacco Nation, because tobacco use is higher in these states than in other parts of the country. Spoiler alert: Ohio is one of these twelve states.

In fact, 22% of the residents in Tobacco Nation reported smoking tobacco in 2015, but in other states it was only 15%. Additionally, people in Tobacco Nation averaged 67 packs of cigarettes per year as opposed to 41 elsewhere. Finally, rural populations used more smokeless tobacco than urban ones, making our youth more susceptible to tobacco use and abuse.

*Wayne County YASUS 2019

• Fewer healthcare resources or less access to those resources (e.g., travel distance to a doctor or limited internet access for virtual medical visits)
• Tobacco ads often target rural residents
• Fewer local policies regarding tobacco sales and use
• Tribal sovereignty

Research shows that the following are effective prevention efforts:

• Positive messaging (e.g., "smoke-free air")
• Reaching out to lawmakers in support of prevention bills, such as Tobacco 21
• Mass media campaigns like Tips From Former Smokers

• Maintain a list of tobacco and e-cigarette retailers
• Provide retailers with education on the tobacco laws they must comply with
• Ensure every retailer in a community is visited each year for a compliance check
• Reduce the density or clustering of retailers
• Restrict businesses located near schools or youth-oriented facilities from selling tobacco
• Reduce sales to youth
• Restrict the types of businesses that can sell tobacco