Between 2006 and 2008, I had the privilege of working as a tobacco prevention youth leader while enrolled as a high school student in Durham Public Schools. My program was part of a statewide network focused on preventing teen tobacco use through peer education – and we were making progress. Tobacco use among high school students steadily declined throughout the early 2000s, from 38.3 percent in 2000 to 25.8 percent in 2009.
It was empowering to be part of the tobacco prevention movement – to know that the work I was doing was saving lives. Even more, it was exciting to see a decline in tobacco use in North Carolina, home to two of the three largest tobacco companies in the United States. This was, however, before prevention funding was cut from the state budget and before the widespread introduction and marketing of e-cigarettes.
Until 2010, the Health and Wellness Trust Fund was receiving just over $17 million a year for tobacco-use prevention and cessation programs. This money came from the approximately $137.5 million North Carolina receives every year as part of the Tobacco Master Settlement Agreement. However, in 2011, the General Assembly cut all state funding for tobacco-use prevention programming. Almost immediately, teen tobacco use in North Carolina began to rise again, increasing almost 4 percent between 2011 and 2013.
At the same time, tobacco companies began heavily marketing e-cigarettes using the same practices that have been outlawed with regard to traditional tobacco products, including television and magazine ads. Without a comprehensive tobacco-use prevention program in North Carolina, there was no one to combat the tobacco industry’s pervasive and predatory marketing of e-cigarettes. So, it is no surprise that e-cigarette use by North Carolina high school students increased a staggering 352 percent between 2011 and 2013 or that e-cigarette use tripled among high school students nationwide in just one year, from 2013 to 2014.
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North Carolina is moving backward. Tobacco use continues to be the No. 1 cause of preventable death in our state. Tobacco companies are marketing e-cigarettes to youth, couching them as “safer” than traditional cigarettes, pitching them as glamorous and cool, while offering child-friendly flavors like banana split and blue raspberry.
It is imperative for our youth to be educated on the dangers of tobacco and e-cigarette use. The prevention programs that were so effectively curbing teen tobacco use in North Carolina must be restored. Funding should again be provided by the tobacco industry via the MSA. By allocating just 12.8 percent of the MSA funds each year ($17.3 million), we can once again provide an effective education program to youth that counters the tobacco industry’s predatory marketing practices.
North Carolina taxpayers would incur no cost from restoring this program funding. Without these programs, however, taxpayers will bear the burden of the $3.81 billion in direct medical costs related to smoking each year and an additional $7.2 billion in future health care costs associated with tobacco use, not including e-cigarette use. Additionally, tobacco use will continue to rise, an estimated 13,180 youth will grow up to become addicted adult smokers and an estimated 4,370 more kids will die prematurely from a smoking-related disease. So, by cutting tobacco-use prevention funding our lawmakers have effectively cost taxpayers billions of dollars and have ensured that the youth tobacco use epidemic will continue in North Carolina.
Every North Carolinian must urge the General Assembly to again appropriate MSA funds for tobacco use prevention programs to save billions of dollars and thousands of lives.
Morgan Wittman Gramann earned her J.D. from the University of North Carolina at Chapel Hill in 2014 and is the Coalition Manager at the North Carolina Alliance for Health.