Teen Tobacco Use Prevention and Cessation Initiative

The Problem

The teen smoking rate has dropped dramatically in recent years, from 27% in 2003 to an historic low of 19% in 2007, according to the Youth Tobacco Survey. While progress is evident, continued efforts are critical to sustain the decline in tobacco use among youth in North Carolina. 

HWTF Solution

Evidence shows that comprehensive school-based programs, combined with community and mass-marketing efforts, can effectively prevent or postpone the onset of youth smoking. HWTF has funded a comprehensive statewide program to address youth tobacco prevention and cessation since 2003, including a grassroots and mass media campaign known as Tobacco.Reality.Unfiltered. (TRU).

Teen Tobacco Grants
Since 2003, HWTF has awarded more than $29.4 million in grant funding to over 60 community and school-based organizations across the state, in all 100 North Carolina counties. All grantees use a comprehensive approach to address four key tobacco control goals as recommended by the Centers for Disease Control and Prevention (CDC): preventing youth initiation, eliminating exposure to secondhand smoke, promoting cessation and eliminating disparities. HWTF also funds the following: 

  • Grants that work exclusively with priority population youth 
  • DHHS / Alcohol Law Enforcement (ALE) of state law prohibiting the sale of tobacco to minors - The January 2005 "Guide to Community Preventive Services" from the CDC states that there is now sufficient evidence that restricting minors' access to tobacco products as part of a comprehensive program is an effective intervention for reducing tobacco use initiation. HWTF provides a grant to DHHS and the Division of Alcohol Law Enforcement (ALE) to provide education and enforcement of the State’s Youth Access to Tobacco Products Law (G.S. 14-313), with emphasis on areas where there is high noncompliance among retailers. As part of this grant, DHHS developed the Red Flag Tobacco Enforcement Campaign. Red Flag augments law enforcement efforts on tobacco sales by publicizing North Carolina’s color-coded driver’s license format (for e.g. red on the license means the holder is underage). 
  • American Lung Association Not On Tobacco (NOT) program – The N-O-T Program is a non-punitive cessation program for teenagers who want to quit tobacco use. This program was developed by the American Lung Association in collaboration with researchers at West Virginia University, whose services have been procured under a sole source contract as prescribed by State Purchasing and Contracting procedures. For more information, visit www.ncnot.com. 
  • Survivors and Victims of Tobacco Empowerment (SAVE) 
  • Spit Tobacco Education Program (NC STEP) (link to NC Spit pages) 
  • Question Why Youth Empowerment Centers

Key Accomplishments

The state of North Carolina has seen dramatic decreases in youth tobacco use rates, a trend that began in 2003 and has continued through 2007.Since HWTF began funding prevention efforts in 2003, middle school smoking has dropped by 51.6% and high school smoking has dropped by 30.4%. This translates into 34,000 fewer teen smokers since 2003.

Social norms related to smoking are showing positive signs of change. In 2007, 80% of middle school students and 51% of high school students had never tried smoking – not even a puff. In 2003, only 70% of NC middle school students and 40% of NC high school students had never tried smoking. 

  • Over 90% of NC youth did not believe that young people who smoke cigarettes had more friends, nor that smoking cigarettes made youth look cool or fit in, nor that smoking made youth look attractive. 
  • High schools that have had a 100% tobacco-free school policy in place for at least four years have 40% fewer youth smokers compared to schools without the policy. 
  • The North Carolina General Assembly passed legislation in 2007 (SB 1086) requiring all NC school districts to adopt and implement a 100% tobacco-free school policy by August 2008. The legislation directed HWTF to assist local school districts with implementation efforts.