Utah is the first state to enact a statewide prohibition on drinking water fluoridation. Gov. Spencer Cox (R) signed the legislation, House Bill 81 (HB 81), on March 27, 2025.

While Utah is the first state to enact a statewide ban, voters in four states—Utah, South Dakota, Oregon, and Washington—considered ballot measures related to water fluoridation during the 1970s.

HB 81 follows Utah Initiative A, which voters approved in 1976 with 50.1% of the vote. Initiative A prohibited the State Board of Health from requiring fluoride and other medications to public water supplies. However, Initiative A allowed fluoridation if voters approved it through local citizen-initiated ballot measures. In 1998, the legislature expanded this by allowing local governing bodies to place fluoridation questions on the ballot. In 2000, voters in Salt Lake County approved a ballot initiative to add fluoride to the public water supplies. HB 81 repealed these provisions—removing the option for local voter-approved fluoridation and prohibiting fluoridation in areas where it had already been authorized, such as Salt Lake County.

Unlike Utah Initiative A, voters in Oregon, Washington, and South Dakota rejected ballot measures to prohibit or restrict fluoridation. South Dakota was the first state to vote on a fluoridation-related measure. In 1970, voters defeated Initiative 1, which sought to repeal a 1969 law requiring fluoride in municipal water; 52% voted no and 48% voted yes. In 1976, Oregon and Washington voters also rejected measures to ban fluoridation—Measure 11 failed 57% to 43% in Oregon, and Initiative 322 failed 65% to 35% in Washington.

HB 81 passed the Utah House of Representatives on March 27 by a vote of 51-19 and passed the Senate the same day by a vote of 18-8. In the House, 50 Republicans and one Democrat voted in favor, while 13 Democrats and six Republicans voted against. In the Senate, the bill was supported by 17 Republicans and one Democrat, with five Democrats and three Republicans voting in opposition.

State Sen. Todd Weiler (R-8), who voted against the bill, said, “I don’t really have a dog in the fight whether we fluoridate our water or not. But I’m not sure I’m comfortable with the legislature telling Salt Lake City, Brigham City, Helper and Davis County that their local authorities can’t do what their residents have voted to do.” Sen. Stephanie Pitcher (D-14), who supported the bill, said Salt Lake County hadn’t voted on the issue since 2000 and that public fluoridation is “incredibly invasive for those individuals who don’t want fluoride in their water.”

The Utah law prohibiting fluoride in public water will go into effect on May 7.