Objectives We examine influences on southeastern state legislators’ actions related to tobacco tax increases. Methods In 2014, we interviewed 26 former state legislators in southeastern states via phone. Results Themes regarding factors impeding increasing tobacco taxes included: tobacco's legacy in the South, protecting vulnerable populations from increased cigarette costs, concern about economic impact, opposing “sin” taxes, concern about impact on reelection, and perceptions that constituents oppose all taxes. The major theme in support of increasing tobacco taxes was health concern. Prior attempts at passing legislation resulted in political leveraging, deal-making, or compromising. Conclusions Legislators’ misperceptions of constituent opposition and impact on economy, among other impediments to increased tobacco taxes, must be addressed.

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