Anti-smoking advocates are making a new push to help people in North Carolina quit.

By Rose Hoban

Each year, about 14,200 people in North Carolina die as a result of diseases related to smoking, and according to the Centers for Disease Control and Prevention more than 180,000 kids younger than 17 will eventually die as a result of smoking-related illness.

N.C. Alliance for Health head Pam Seamans (at podium, center) introduces partners for the Race of Quit NC campaign Tuesday.
N.C. Alliance for Health head Pam Seamans (at podium, center) introduces partners for the Race to Quit, NC campaign Tuesday. Photo credit: Rose Hoban

If you thought state lawmakers have responded to these statistics, you’d be wrong, said Pam Seamans, head of the North Carolina Alliance for Health, at a press event in Raleigh on Tuesday.

“The 2016 budget, which was just signed last month by Gov. McCrory, contains just one line item dedicated to helping North Carolinians quit smoking,” Seamans said, referring to the 429-page budget passed in late September.

Seamans was kicking off a campaign of tobacco-prevention and -cessation events scheduled throughout October geared at helping people learn more about how to quit smoking (see box).

Race to Quit, NC is intended to help people find resources and tools to quit smoking. The coalition includes physician groups, county health departments, hospitals, advocacy organizations such as the American Lung Association and the state Department of Health and Human Services.

“We are filling a void left by our state legislators, who have slashed tobacco-use prevention and cessation budgets in recent years,” said Seamans, noting that the state budget only contains $1.2 million to fund the N.C. Quitline.

“At this funding level of $1.2 million, QuitlineN.C. can only reach 1 percent of tobacco users,” she said.

Department of Health & Human Services undersecretary Randall Williams said as lawmakers implement Medicaid reform, there's an opportunity for adding prevention to the plan. Photo credit: Rose Hoban
The DHHS’ Randall Williams said that as lawmakers implement Medicaid reform there’s an opportunity for adding prevention to the plan. Photo credit: Rose Hoban

Unspent money, big costs

North Carolina receives about $140 million as a result of the 1999 master agreement with tobacco companies to help pay for the cost of treating tobacco-related diseases. The CDC recommends that North Carolina spend about $99.3 million per year to help people quit and to help prevent new smokers from starting.

Seamans said North Carolinia’s low investment has resulted in rates of smoking that are higher than in many other states; about one in five state residents smoke, and about 13 percent of high school students are smokers.

“Just about every organ in the body is affected” by smoking, said James Davis, medical director of the Duke Center for Smoking Cessation. “And this is something that I think the general public has not really come to understand.”

Davis said that smoking is implicated as a contributing or causative factor for more than 14 kinds of cancers, including cervical, bladder and lung cancer.

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Race to Quit, NC events

Freedom From Smoking® group clinic – Forsyth County Department of Public Health, Oct. 5Nov. 16

√ Mecklenburg County Employee Fest 2015 – Freedom Park in Charlotte, Oct. 8

√ Society for Public Health Education, N.C. Chapter, 50th Annual Meeting – Hickory, Oct. 8-9

√ Free Nicotine Replacement Therapy – Orange County Health Dept., Oct. 12-Nov. 9

To find more events, click here


Smoking also causes vascular disease, which contributes to heart attacks and strokes.

“When we look at the incidence of death … related to smoking, it’s because of all of these cancers, all the lung diseases, all of the vascular diseases coming together,” Davis said. “What we end up with is new information that tells us that 50 percent of smokers will die of a smoking-related illness.”

Seamans estimated the tab for treating smoking-related illnesses is about $3.8 billion, plus an additional $4.8 billion in lost wages and productivity per year in North Carolina.

“And yet … what has been covered all summer and into the fall? It’s redoing Medicaid and reforming Medicaid and bringing down Medicaid costs,” Seamans said. “And approximately $930 million in Medicaid expenditures goes to tobacco-related illness.”

“It’s bleeding budgets all over,” she said.

Six attempts

Davis said the patients he sees want to quit, but can’t.

“These are people who are not weak of will power,” he said. “These are people who have productive jobs, who have good family relationships, they’re productive members of society. But they are engaged in an addictive behavior that is incredibly powerful.”

Davis said he grew up in Western North Carolina and worked the tobacco fields as a boy. Many of his friends became addicted to nicotine.

“Neuroscience now shows us that the addictive processes in smoking are very similar to the addictive processes in heroin or opiate addiction,” he said. But, he added, “smokers are not driving off the road, they’re not coming home and beating up their family members, they’re not becoming homeless. So we don’t see the immediate impacts of smoking intoxication.”

Davis said that his patients who  are both alcoholics and smokers find it more difficult to give up smoking than drinking.

And most smokers try at least six times to quit before succeeding.

Using e-cigarettes is not the answer to quitting, Davis said.

“When you look out on the market, there are hundreds of different varieties of e-cigarette-type devices,” he said. “Some have very high levels of nicotine, some have very low levels of nicotine. These have not been developed by pharmaceutical companies, they’ve been developed by tobacco companies, and so they’re not going through the same evaluation that drugs get.”

Instead, Davis said, using nicotine replacement along with counseling and support and, in some cases, medication greatly increase a smoker’s chances of quitting.

“We don’t have a one-size-fits-all therapy for smokers, ” he said. “We have powerful tools, and smokers really need to do whatever they can to engage them.”

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