Tobacco product use during adolescence increases the risk for lifelong nicotine addiction and adverse health consequences. Smoking-caused health care costs: $3.61 billion per year. In 2022, 7.7% of adults in Virginia used e-cigarettes. Nationally, adult e-cigarette use prevalence was 7.7%. In 2022, 3.1% of adults in Virginia used smokeless tobacco every day or some days. Nationally, adult smokeless tobacco use prevalence was 3.4%. Virginia is ranked 44th in the U.S. for its cigarette tax of 60 cents per pack (enacted July 2020), compared to the national average $1.93.