Reduce the use of commercial tobacco

A persistent barrier to health in Minnesota

Commercial tobacco use remains a significant barrier to improving health outcomes in Minnesota and is the single most preventable cause of disease, disability, and death in the United States. While the smoking rates in Minnesota have steadily declined over the last two decades, commercial tobacco use continues to contribute to preventable illness and death across the state.

In 2021, smoking was responsible for $4.7 billion in excess healthcare costs and 6,527 deaths in Minnesota. Commercial tobacco use is linked to serious health conditions, including heart disease, cancer, and respiratory illness, and remains a leading driver of poor health outcomes.

Commercial tobacco refers to manufactured products that are sold for profit, including cigarettes, cigars, and e-cigarettes. This is distinct from the traditional use of tobacco by Indigenous communities for spiritual and medicinal purposes.

New and evolving commercial tobacco products — flavored and menthol options — continue to shape commercial tobacco use. These products can make initiation easier and quitting more difficult, contributing to ongoing use.

Despite Minnesota’s overall progress, gaps in health outcomes persist, with some populations experiencing higher rates of commercial tobacco use and exposure to secondhand smoke. Addressing commercial tobacco use remains critical to improving health outcomes statewide.

Current initiatives and programs

Creating a tobacco-free future for all Minnesotans

HOPE Initiative: The HOPE initiative is designed to support communities disproportionately affected by commercial tobacco. The initiative collaborates with 7 organizations and 3 Tribal Nations to continue moving toward a shared goal of reducing and eliminating the harms of commercial tobacco and supporting traditional tobacco teachings. Funded projects advance policies, systems, and environmental changes in communities targeted by the tobacco industry.

MSFG Coalition: Co-chaired by Blue Cross and Blue Shield of Minnesota, Minnesotans for a Smoke-Free Generation is a coalition of over 40 community organizations leading the fight against youth commercial tobacco use. The coalition supports policies like Tobacco 21, keeping tobacco prices high, limiting access to candy, fruit, and menthol flavored tobacco. More recently, Minnesotans for a Smoke-Free Generation was key in successfully advocating for two state policies passed in 2023 to further reduce commercial tobacco addiction. The new legislation:

• Dedicates Juul settlement funding to the Minnesota Department of Health’s commercial tobacco prevention and cessation efforts
• Expands Medicaid coverage for tobacco treatment and broadens the types of providers that can bill for reimbursement

Project WATCH: Project WATCH focuses on identifying and tracking commercial tobacco industry marketing tactics such as price promotions, contests, product launches and rebranding initiatives. This program also focuses on educating city, county, state and school decision-makers about commercial tobacco control best practices and providing technical assistance to commercial tobacco control partners across the state. Since 2010, Project WATCH has reviewed more than 10,000 commercial tobacco industry direct mail marketing pieces and more than 36,000 commercial tobacco industry emails. This information is presented locally and nationally through presentations, conferences, webinars and a quarterly newsletter. This surveillance project allows us to stay on top of an ever-evolving industry and is essential to helping develop and advocate for effective tobacco control policies.

Past achievements

Our commitment for more than 25 years

Blue Cross and Blue Shield of Minnesota has taken a leading role in efforts to eliminate the harms of commercial tobacco use by supporting community-driven work that raises awareness, shifts cultural and social norms, and influences local and organizational policy.  In the early 1990s, Blue Cross joined the State of Minnesota as a co-plaintiff in landmark litigation against the tobacco industry. As a result of that case, Blue Cross received settlement funds in 2006 and committed to reinvest $241 million to improve health outcomes across Minnesota. This ongoing commitment reflects a sustained effort to reduce commercial tobacco use statewide and in communities most impacted by poor health outcomes.

Our past work includes:

Freedom to Breathe amendment: Blue Cross played an instrumental role in passing the Freedom to Breathe amendment to the Minnesota Clean Indoor Air Act in 2007, which protects employees and the public from the health hazards of secondhand smoke.

Tobacco 21: Blue Cross supported the passage of Tobacco 21, which raised the sale age of commercial tobacco from 18 to 21.

CETI Initiative 2015-2018: The CETI initiative supported community-driven efforts to raise awareness, shift social and cultural norms, and influence organizational and local public policy related to commercial tobacco use.

Teen Vaping Documentary: Flavored products and targeted marketing by the commercial tobacco industry have driven high youth tobacco use in Minnesota, with most high school users using flavored products and widespread exposure to e-cigarette advertising contributing to increased vaping. Watch the video here.

Health POWER 2020-2023: Health POWER was a multi-year funding initiative focused on strengthening leadership and supporting community-led solutions to improve health outcomes in commercial tobacco control, healthy eating, and physical activity.

The Cost of Smoking Report: Commissioned by Blue Cross and Blue Shield of Minnesota, the 2023 Cost of Smoking report highlights the significant health and economic impacts of commercial tobacco use—including $4.7 billion in annual healthcare costs and more than 6,500 deaths—underscoring the need for continued action to reduce tobacco-related harm and improve health outcomes statewide.

Throughout the years, our commitment to commercial tobacco control has stood strong. We continue to support and advocate for legislation that keeps Minnesotans safe from the harms of commercial tobacco, commission cost of smoking reports that highlight the urgent need for comprehensive measures to address smoking-related health issues in Minnesota, and fund community organizations that share our goal of eliminating the harms of commercial tobacco.