Highlights: North Carolina

Tobacco use remains the leading cause of preventable death and disease in the United States. To address this enormous toll, the American Lung Association and its partners have committed to three bold goals:
1. Reduce smoking rates, currently at about 18 percent, to less than 10 percent by 2024;
2. Protect all Americans from secondhand smoke by 2019; and
3. Ultimately eliminate the death and disease caused by tobacco use.

The American Lung Association in North Carolina recognizes that these bold goals will only be met in North Carolina if these following three actions are taken by our elected officials:
1. Restore funding for tobacco use prevention programs;
2. Resist threats or attempts to weaken the Smoke-Free Restaurants and Bars Law and expand the law to include all public places and private worksites;
3. Increase funding for state tobacco cessation, including QuitlineNC.

Much of the activity in the 2014 legislative session related to tobacco control focused on electronic cigarettes. After the consideration of several amendments related to the electronic cigarette tax, House Bill 1050 was approved by the full House. Buried in this large tax-related bill was a provision to tax electronic cigarettes at 5 cents per milliliter of consumable product, far below the current tax on traditional cigarettes of 45 cent per pack, which is already the 5th lowest rate in the country. An amendment to the bill was later introduced and subsequently approved that defined electronic cigarettes as "vapor products" but did include the term vapor product within the definition of "tobacco product." The U.S Food and Drug Administration intends to regulate e-cigarettes as tobacco products.

In the state House of Representatives budget, through an amendment proposed during the House floor budget debate, a provision to include funding for the You Quit Two Quit smoking cessation program for women of reproductive age was included. The program is a partnership between the North Carolina Health and Wellness Trust Fund and the Center for Maternal and Infant Health at the University of North Carolina. However, another amendment, which received unanimous support, substituted no-cost language in the House budget to make nonprofit programs such as You Quit Two Quit eligible for competitive grants from an existing pool of money. Unfortunately, there is no certainty that any pregnancy prevention programs will be funded through this competitive process.

There was little debate on funding for tobacco use prevention programs. Two years ago (in FY 2012), tobacco prevention and cessation programs received an appropriation of $2.7 million, which included $1.9 million for QuitlineNC and $830,000 for tobacco prevention programs. As recently as 2011, tobacco prevention and cessation programs jointly received $17.3 million. With just $1.2 million appropriated in 2014 for the Quitline, there has been a devastating funding cut of 94 percent over the last two years.

The American Lung Association in North Carolina will continue to partner with the North Carolina Alliance for Health as it defends against further attacks to weaken the Smoke-Free Restaurants and Bars Law and weighs options for strengthening protections for nonsmokers. Emphasis will also be placed on restoring funding for tobacco use prevention programs through the North Carolina Health and Wellness Trust Fund to previous levels and to increase funding for Quitline NC.

North Carolina State Facts

Economic Cost Due to Smoking: $6,281,486,000
Adult Smoking Rate: 20.3%
High School Smoking Rate: 13.5%
Middle School Smoking Rate: 2.5%
Smoking Attributable Deaths: 12,264
Smoking Attributable Lung Cancer Deaths: 4,027
Smoking Attributable Respiratory Disease Deaths: 3,142

Adult smoking rate is taken from CDC's 2013 Behavioral Risk Factor Surveillance System. High school and middle school smoking rates are taken from the 2013 North Carolina Youth Tobacco Survey.

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