Photo credit: Valentin Ottone, flickr creative commons


Neither the House nor the Senate budget has allocated any funding for youth tobacco-prevention programs.

By Rachel Herzog

In 2011, North Carolina’s youth smoking rate hit an all-time low. In 2013, the state hit another low: Legislators reduced funding for tobacco control and prevention programs to zero, and it’s stayed there ever since.

Photo credit: Valentin Ottone, flickr creative commons
Tobacco-use rates among high school students rose from 25.8 percent in 2011 to 29.7 percent in 2013. Photo courtesy Valentin Ottone, flickr creative commons

Tobacco use rates among high school students rose from 25.8 to 29.7 percent in those years, according to the North Carolina Youth Tobacco Survey.

Pam Seamans, executive director of the North Carolina Alliance for Health, said this pattern will continue if legislators don’t prioritize prevention and re-implement the programs the state once had.

“We need to restore these education programs or we will see our youth experimenting with new and traditional tobacco products,” she said.

A pattern of cuts

In 2011, the legislature allotted $17.3 million for youth tobacco-prevention programs. These programs included Tobacco. Reality. Unflitered., a teen prevention campaign that won national awards and was replicated in multiple states.

In 2012, tobacco-prevention funding dropped to $2.7 million, then down to zero in 2013.

N.C. current tobacco users by gender. Data source: N.C. Youth Tobacco Survey, 2013
N.C.’s current teen tobacco users by gender. Data source: N.C. Youth Tobacco Survey, 2013

“When funding was at its most robust, at $17.3 million, we had the lowest teen tobacco rate that North Carolina had ever seen,” said Ray Riordan, state grassroots lobbying director for the American Cancer Society Cancer Action Network. “We don’t think it’s a coincidence that since the funding has been pulled, we’ve seen an increase in tobacco use.”

Riordan and other ASC CAN members gathered at the legislature Wednesday morning to ask lawmakers to reconsider.

“Clearly, something is not right. We’ve got the money,” he said, referring to the approximately $140 million the state will get this year from the 1998 Master Settlement Agreement with tobacco companies.

That settlement was intended to remediate the harm tobacco had caused the state by paying for health care for people suffering from lung and heart diseases.

Right now, this money goes to the state’s general fund.

Seamans said the fact that these funds are available but not being used to pay for prevention programs makes the loss of funding especially disappointing.

“There is a way to pay for these programs,” she said. “They have chosen not to use these funds.”

Currently, the House and Senate budgets allot $1.2 million for QuitlineNC, which provides all North Carolinians with free tobacco-cessation services, but there’s nothing specifically for teens. Seamans said that’s not enough, especially in light of the CDC’s recommendation that North Carolina should be spending $99 million on tobacco-cessation programs.

“It just makes no sense,” she said.

Alternative addictions

Youth tobacco-use rates weren’t the only thing that increased between 2011 and 2013. Use of alternative tobacco products, such as e-cigarettes and hookahs, rose by 352 percent.

Since funding for North Carolina's teen smoking cessation program was cut, more teens are using nicotine, either by lighting up or using e-cigarettes.
Since funding for North Carolina’s teen smoking-cessation program was cut, more teens are using nicotine, either by lighting up or using e-cigarettes. Photo courtesy Nerissa’s Ring, flickr creative commons

“That is showing that our youth are trying new products,” Seamans said.

The legal age to purchase e-cigarettes is 18, but that doesn’t mean kids aren’t getting them, she said, adding that with flavors like bubblegum and watermelon available, they’re attractive to youth.

E-cigarettes are not subject to the same advertising restrictions as traditional tobacco products, nor are they taxed at the same rate. While e-cigarettes are often marketed as a healthier alternative to regular cigarettes, the exact level of harm is not known, and they contain high levels of nicotine.

“It’s safe to assume until evidence shows e-cigarettes are absolutely safe, they should be treated the same as tobacco,” Seamans said.

A new 5-cent-per-milliliter tax on e-cigarettes goes into effect June 30.  One milliliter usually contains the same amount of nicotine as in a pack of cigarettes.

“The North Carolina Alliance for Health was very disappointed in this e-cigarette tax because it was a low tax,” she said. “It’s going to be interesting to see how much money the vapor tax really does yield. We will be advocating for that to be put toward youth tobacco-prevention programs.”

A new bill

A bill to tax e-cigarettes at the same rate as all other tobacco products has been filed but has been waiting to be heard in committee since April. If passed, House Bill 939 would raise the e-cigarette tax to 12.8 percent of the product cost and produce more than $20 million in annual revenue, which would fund tobacco-prevention programs.

“We have worked very hard in this state, a great tobacco state, to have a strong tobacco-prevention program, but unfortunately this legislature has eliminated all of our provision funding,” Rep. Joe Sam Queen (D-Waynesville), the bill’s primary sponsor, said. “We need to restore it.”

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