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California was one of the first states to implement Tobacco 21 policies

However, it was alarming to see that, overall, there was an increase in daily e-cigarette use among adults, with the largest increase among those aged 21 to 24 years. The study authors used data from the 2017 to 2020 Behavioral Risk Factor Surveillance System to study e-cigarette use among more than 429,000 U.S

In the 2026 report, West Virginia received the following grades: Funding for State Tobacco Prevention Programs Grade F Strength of Smokefree Workplace Laws Grade D* Level of State Tobacco Taxes Grade F Coverage and Access to Services to Quit Tobacco Grade D Ending the Sale of All Flavored Tobacco Products Grade F Federal Grades Overview The 2026 State of Tobacco Control report grades the federal government in five areas: Federal Regulation of Tobacco Products Grade D Federal Coverage of Quit Smoking Treatments Grade D Level of Federal Tobacco Taxes Grade F Federal Mass Media Campaigns to Prevent and Reduce Tobacco Use Grade I* Federal Funding for Tobacco Prevention and Control Grade: B *The federal government gets an I for Incomplete in this category due to data not being able to be obtained about the duration, reach and frequency of the Real Cost campaign in 2025

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