20th Annual ‘State of Tobacco Control’ Report Reveals North Carolina Still Lags

New report reveals North Carolina earned failing grades on passing policies to reduce and prevent tobacco use, including e-cigarettes

The American Lung Association’s 20th annual “State of Tobacco Control” report, released today, reveals significant progress in the work to end tobacco use, but products like e-cigarettes and other flavored tobacco products, including menthol cigarettes, create concern for losing another generation to nicotine addiction. 

The “State of Tobacco Control” report evaluates state and federal policymakers on actions taken to eliminate tobacco use, the nation’s leading cause of preventable death. The report recommends proven-effective tobacco control laws and policies to save lives. The 2022 “State of Tobacco Control” reveals that the country has made substantial progress in advancing tobacco control policies over the past 20 years, including comprehensive smokefree laws in more states, increased tobacco taxes across the nation and more Americans with access to treatments to help them quit smoking through state Medicaid programs. 

Most recently, North Carolina State Attorney General Josh Stein held JUUL Labs accountable for marketing to kids, producing a settlement requiring JUUL to pay $40 million over the next six years, however, there is more work to be done. The smoking rate is still 16.5%, and the high school tobacco use rate is 27.3%. 

“Tobacco use remains our leading cause of preventable death and disease in North Carolina, taking an estimated 14,220 lives each year,” said Dr. John Doty, American Lung Association Local Leadership Board member and pulmonologist at Atrium Health “And our progress on tobacco control policy has not been equal. We continue to see the unequal burden of tobacco use and exposure to secondhand smoke in communities experiencing health disparities.”

North Carolina’s Grades 
“State of Tobacco Control” 2022 grades states and the District of Columbia in five areas that have been proven to prevent and reduce tobacco use and save lives. North Carolina received the following grades: 

1.    Funding for State Tobacco Prevention Programs – Grade F
2.    Strength of Smokefree Workplace Laws – Grade F
3.    Level of State Tobacco Taxes – Grade F
4.    Coverage and Access to Services to Quit Tobacco – Grade F
5.    Ending the Sale of All Flavored Tobacco Products   - Grade F 

This year’s report noted the need for North Carolina policymakers to focus on expanding Medicaid to provide quality and affordable healthcare to over 212,000 uninsured North Carolina residents. This coverage would increase access to quit-smoking treatments for North Carolinians, as Medicaid expansion plans are required to cover preventive services, including cessation treatment without cost-sharing. States that have expanded their Medicaid programs to 138% of the federal poverty level, approximately $2,525/ month for a family of three, have seen measurable increases in quit attempts among Medicaid enrollees. 

It is also vital that state policymakers focus on increasing funding for tobacco prevention and quit smoking programs. An investment in prevention is especially important given the ongoing youth vaping epidemic. “Despite receiving $458,100,000 from tobacco settlement payments and tobacco taxes, none of these funds are directed to tobacco use prevention programs. The Lung Association believes these funds should also be used to support the health of our communities, and to prevent tobacco use and help people quit, and not switch to e-cigarettes. These programs are also critical for helping to end tobacco-related health disparities,” said Jennifer Hall, Executive Director for the American Lung Association.

Federal Grades Overview
“State of Tobacco Control” 2022 also grades the federal government in five areas: 
⦁    Federal Government Regulation of Tobacco Products (2022 grade – D)
⦁    Federal Coverage of Quit Smoking Treatments (2022 grade – D)
⦁    Level of Federal Tobacco Taxes (2022 grade – F)
⦁    Federal Mass Media Campaigns to Prevent and Reduce Tobacco Use (2022 grade – A)
⦁    Federal Minimum Age of Sale for Tobacco Products to 21 (2022 grade – I*)

* The Incomplete grade is for the FDA being more than 18 months overdue in publishing the final Tobacco 21 regulations as required by statute.

“In 2022, North Carolina needs to redouble its efforts to pass the proven policies called for in ‘State of Tobacco Control’ to help end tobacco use. We cannot afford to wait 20 more years and allow another generation to suffer from tobacco-caused addiction, disease and death,” said Hall.

For media interested in speaking with an expert about the “State of Tobacco Control” report, lung health, tobacco use and tobacco control policies, contact the American Lung Association at [email protected]  or 704-818-4138. 

For more information, contact:

Jill Smith
[email protected]

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