New Report: North Carolina Must Focus on Increasing Funding for Tobacco Control to Save Lives

North Carolina lags behind country in 22nd annual “State of Tobacco Control” report; American Lung Association outlines steps to reduce burden of tobacco use

A new report from the American Lung Association urges North Carolina lawmakers to focus on increasing funding for tobacco control in the state to reduce the burden of tobacco use. The 2024 “State of Tobacco Control” report, now in its 22nd year, evaluates state and federal policies on actions taken to eliminate tobacco use and recommends proven-effective tobacco control laws and policies to save lives. North Carolina received four “F” grades and one “D” grade for policies to improve statewide efforts to prevent and reduce tobacco use.

“Tobacco use is the leading cause of preventable death and disease in North Carolina and across the country, claiming the lives of 14,220 residents each year,” said Danna Thompson, director of advocacy at the American Lung Association in North Carolina. “The tobacco industry will do anything to protect their profits at the expense of North Carolinians, so we must push forward in our efforts to prevent and reduce tobacco use.”

Thompson added: “North Carolina has made substantive progress in the past year. Thanks to the leadership of the North Carolina General Assembly in passing the Medicaid expansion, up to 600,000 people now have coverage for tobacco cessation treatment. We are grateful for the leadership of our local lawmakers and look forward to working together to continue the momentum on behalf of our communities.”

North Carolina’s Grades

The “State of Tobacco Control” report grades states and the District of Columbia in five areas that have been proven to prevent and reduce tobacco use and save lives. In the 2024 report, 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 D
  5. Ending the Sale of All Flavored Tobacco Products – Grade F

To address the toll of tobacco use in North Carolina, the Lung Association calls for the following actions to be taken by local elected officials:

  1. Implement a comprehensive tobacco retail licensing system, including e-cigarette retailers;
  2. Increase the cigarette tax to the current average cigarette tax and equalize taxes for all tobacco products, including e-cigarettes; and
  3. Rollback preemption of stronger local laws in North Carolina regarding tobacco use and prevention.

Federal Grades Overview

This year’s report focuses on recent federal actions, including President Biden’s failure to finalize rules to end the sale of menthol cigarettes and flavored cigars, as well as FDA’s overdue review of all applications for e-cigarette products, including flavors that are popular among youth. Because of the delay on the federal rules to end the sale of menthol cigarettes and flavored cigars, it is even more important for states to enact laws to end the sale of all flavored tobacco products.

The 2024 “State of Tobacco Control” report grades the federal government in five areas:

  • Federal Government Regulation of Tobacco Products – Grade C
  • Federal Coverage of Quit Smoking Treatments – Grade D
  • Level of Federal Tobacco Taxes – Grade F
  • Federal Mass Media Campaigns to Prevent and Reduce Tobacco Use – Grade: A
  • Federal Minimum Age of Sale for Tobacco Products to 21 – Incomplete**

The Lung Association calls on the White House to urgently finalize rules to end the sales of menthol cigarettes and flavored cigars in the U.S. to save lives now. Send an email to President Biden at to insist these rules be finalized urgently. To learn more about this year’s “State of Tobacco Control” grades and take action, visit

Get involved and help the mission of the American Lung Association. The Fight For Air Climb Charlotte at the VUE is coming up on March 23. Learn more at

*State Funding for Tobacco Prevention Programs grades in “State of Tobacco Control” reflect actions taken by elected officials and do not reflect on the hard work of state tobacco control programs or advocates.

**FDA remains grossly overdue in publishing the final Tobacco 21 regulations as required by statute, which is why it earns an “incomplete.” 

For more information, contact:

Victoria O'Neill
(312) 273-5890
[email protected]

Asthma Basics Workshop - National
, | Feb 21, 2024
Asthma Basics Workshop - National
, | Mar 20, 2024