Data Sources and Methods

Data are from an online rapid-response survey conducted by The Harris Poll sponsored by the American Cancer Society in two waves from April to May of 2023 and 2024. The survey sampled 12,300 adults aged 18–65 from 13 high-tobacco-burden states (Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Ohio, Oklahoma, South Carolina, Tennessee, West Virginia) and 4 low-tobacco-burden comparison states (California, Illinois, Maryland, and Virginia). There were 350 respondents per high-tobacco-burden state per wave, while comparison states included an additional oversample of 50 current smokers to enhance analytic power. The survey captured detailed information on tobacco use behaviors, product preferences, cessation efforts, and sociodemographic characteristics.

The survey included validated items from national surveys such as the Population Assessment of Tobacco and Health (PATH) Study, The Behavioral Risk Factor Surveillance System (BRFSS) survey, and The National Youth Tobacco Survey (NYTS), covering tobacco and cannabis use, harm perceptions, policy attitudes, and cessation access. The rapid-response format allows for near real-time insights, enabling timely policy and programmatic responses in high-tobacco-burden states. Data were weighted to reflect state-level population distributions, and adjusted for key demographics (e.g., age, gender, race/ethnicity, education, and smoking status) and probability of being online.

While the methodology was designed to ensure representativeness across key demographic groups, the findings are intended to provide a snapshot of current trends rather than longitudinal insights. Nonetheless, these data offer a robust foundation for understanding regional disparities in tobacco use and informing targeted public health strategies.