Did your state make the grade?
  • F

    Tobacco Prevention and Cessation Funding

  • F

    Smokefree Air

  • F

    Tobacco Taxes

  • F

    Access to Cessation Services

  • F

    Flavored Tobacco Products


The American Lung Association calls for the following actions to be taken by North Carolina's elected officials to reduce tobacco use and exposure to secondhand smoke:
1. Increase state funding to $17 million for tobacco control programs, including prevention, education and cessation;
2. Establish licensing for all tobacco retailers, including electronic cigarette retailers; and
3. Support a tobacco tax increase of $1.37 to reach the national state average as of October 2020 of $1.82 and equalize the tax for all tobacco products including e-cigarettes to the cigarette tax.

Tobacco Prevention and Cessation Funding

  • FY2021 State Funding for Tobacco Control Programs: $1,850,000
  • FY2021 Federal Funding for State Tobacco Control Programs: $2,309,482*
  • FY2021 Total Funding for State Tobacco Control Programs: $4,159,482
  • CDC Best Practices State Spending Recommendation: $99,300,000
  • Percentage of CDC Recommended Level: 4.2%
  • State Tobacco-Related Revenue: $447,400,000

*Includes tobacco prevention and cessation funding provided to states from the Centers for Disease Control and Prevention.

Overall Grade:

F

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Smokefree Air

Overview of State Smoking Restrictions:

  • Government Workplaces: Restricted (prohibited in state government buildings)
  • Private Workplaces: No provision
  • Schools: Prohibited (public schools only)
  • Childcare Facilities: Restricted
  • Restaurants: Prohibited
  • Bars: Prohibited (allowed in cigar bars)
  • Casinos/Gaming Establishments: N/A (tribal casinos only)
  • Retail Stores: No provision
  • Recreational/Cultural Facilities: No provision
  • E-Cigarettes Included: No
  • Penalties: Yes
  • Enforcement: Yes
  • Preemption/Local Opt-Out: Yes (private workplaces and other specific venues)

Citation: N.C. GEN. STAT. §§ 130A-491 to 130A-498 (2010), 115C-407 (2007), 131D-4.4 (2007) & 131E-114.3 (2007).

Overall Grade:

F

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Tobacco Taxes

Cigarette Taxes

  • 45 cents
Other Tobacco Product Taxes:
  • Tax on little cigars: Equalized: Yes; Weight-Based: No
  • Tax on large cigars: Equalized: Yes; Weight-Based: No
  • Tax on smokeless tobacco: Equalized: Yes; Weight-Based: No
  • Tax on pipe/RYO tobacco: Equalized: Yes; Weight-Based: No
  • Tax on Dissolvable Tobacco Products: Equalized: No; Weight-Based: Yes

Overall Grade:

F

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Thumbs Down

Thumbs down for North Carolina for having the fourth lowest cigarette tax in the country.

Access to Cessation Services

Overview of State Cessation Coverage:

State Medicaid Program:

  • Medications: All 7 medications are covered
  • Counseling: Some counseling is covered
  • Barriers to Coverage: Minimal barriers exist to access coverage
  • Medicaid Expansion: No

State Employee Health Plan(s):

  • Medications: All 7 medications are covered
  • Counseling: Some counseling is covered
  • Barriers to Coverage: Some barriers exist to access coverage

State Quitline:

  • Investment Per Smoker: $1.39; the median investment per smoker is $2.28

Other Cessation Provisions:

  • Private Insurance Mandate: No provision
  • Tobacco Surcharge: Limits tobacco surcharges

Citation: See Tobacco Cessation Coverage page for specific sources.

Overall Grade:

F

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Flavored Tobacco Products

Restrictions on Flavored Tobacco Products:

  • No state law or regulation

Overall Grade:

F

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LUNG FORCE Expo
, | Jun 24, 2021