First comprehensive report on state's multiple tobacco programs shows major successes

Tuesday, December 16, 2008 — North Carolina is making huge strides in tobacco use prevention and cessation, according to the first comprehensive evaluation of the state’s multiple tobacco programs, recently released by University of North Carolina at Chapel Hill researchers.

The North Carolina Health and Wellness Trust Fund spends $17 million annually to fund tobacco use prevention and cessation programs for teens and college students, as well as QuitlineNC, a telephone support service for people who want to quit using tobacco. The trust fund was created in 2000 to receive 25 percent of the state’s share of the Master Settlement Agreement.

The report – prepared for the trust fund by the UNC School of Medicine’s Tobacco Prevention and Evaluation Program – says that many of the gains made in the last year, as well as since the trust fund began funding programs five years ago, are models for other states across the U.S.

“According to a recent report from the Campaign for Tobacco-Free Kids marking the 10th anniversary of the Master Settlement Agreement, most states are not spending enough of their money on tobacco prevention,” said Dr. Adam Goldstein, UNC program director. “But relative to other major tobacco-producing states, our evaluation shows North Carolina’s investment in youth tobacco prevention is substantial, and the positive outcomes that have resulted are truly encouraging.”

The UNC report’s findings and highlights include:

  • In 2007, teen tobacco use among North Carolina youths dropped to the lowest levels ever recorded. Cigarette use among middle school students declined to 4.5 percent from 5.8 percent in 2005, and cigarette use by high school students also dropped to 19 percent from 20.3 percent in 2005.
  • That rate of decline has increased much more rapidly since the trust’s funding of community and school grants and media campaigns began in 2003. For example, while cigarette use among high school students declined by 13.6 percent from 1999 to 2003, the decline more than doubled (by 30.4 percent) from 2003 to 2007.
  • By the summer of this year, all 115 North Carolina school districts had adopted 100 percent tobacco-free policies. Researchers described the milestone as a historic accomplishment, largely due to efforts by the trust fund and its grantees.
  • The report describes the trust fund’s Tobacco-Free Colleges program as a model initiative to address the very high rates of tobacco use among young adults aged 18 to 24. In the past two years, 17 North Carolina college campuses have adopted comprehensive tobacco-free campus policies, including at sporting events and in dorms, making North Carolina a national leader in such efforts.
  • A strong statewide youth empowerment movement, with nearly 2,000 youths active in local communities advocating for teen tobacco use prevention and cessation strategies. Since the trust fund’s Teen Tobacco Use Prevention and Cessation Initiative began, youths and their community supporters have helped promote the adoption of more than 700 tobacco-free policies in youth-frequented venues such as restaurants or churches.
  • More youth and young adult smokers contacted QuitlineNC in 2007-2008 for smoking cessation assistance than ever before. During its third year of operation, 1,631 youths and young adults called the service. Youth calls increased by 31.5 percent and young adult calls increased by 63 percent.

The report highlights a number of challenges that remain, including loss of program funding to maintain program effectiveness; the fact that tobacco use remains high among young adults aged 18 to 24 who are not in college; the high number of youths who still report frequent exposure to secondhand smoke (half of middle school students and more than 60 percent of high school youths); and the large number of adult smokers who have insufficient support in quitting.

Among the recommendations for the program’s future are: expanding it to include young adults aged 18 to 24 who are not in college; new efforts to further reduce youth exposure to secondhand smoke; and an expansion of the Tobacco-Free Colleges Initiative to include off-campus areas.

A copy of the report is available at

NC Health and Wellness Trust Fund Web site:

School of Medicine contact: Tom Hughes, (919) 966-6047,
News Services contact: Patric Lane, (919) 962-8596,