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NC Department of Health and Human Services
NC DPH: Chronic Disease and Injury Section
N.C. Public Health Home

Tobacco Prevention and Control Branch

Youth Tobacco Use Prevention

NC DPH E-Cigarette Health Advisory Materials

The Tobacco Prevention and Control Branch, N.C. Chronic Disease and Injury Section, issued these materials to educate health care providers, school leaders, parents and other care givers and the public on the pressing issue of young people’s use of electronic cigarettes and similar nicotine delivery devices.

Teen Tobacco Use Rates

Almost 90 percent of adult smokers became addicted to tobacco products at or before age 20. The 2011 NC Youth Tobacco Survey found that 39.9 percent of high school students had ever smoked cigarettes.

Each day in the US, more than 4,000 teens try their first cigarette and nearly half become regular, daily smokers. Of those, about half will eventually die from a smoking-related disease.

In recent years, North Carolina has recorded significant decreases in cigarette smoking by young people. North Carolina’s middle school smoking rate decreased by 51.8 percent between 2003 and 2007, dropping from a rate of 9.3 percent to 4.5 percent. Similarly, North Carolina’s high school smoking rate decreased by 30.4 percent between 2003 and 2007, dropping from 27.3 percent to 19 percent. Cigarette smoking rates among high school students had dropped to 15.5 percent and middle school students to 4.2 percent by 2011.

In real numbers, that decline amounts to 53,000 fewer underage smokers in North Carolina in 2012 than there were in 2003. This reduction in teen smoking will result in fewer lives lost prematurely, and a savings in health care costs in the future.

For additional information on teen tobacco use rates, visit the Research and Data section of our website.

Spit/Chew Tobacco

Spit tobacco is not a safe alternative to smoking. There are many terms to describe spit tobacco, including smokeless, chewing tobacco, and snuff. The use of spit tobacco can cause cancer, heart disease and stroke.

CDC Prevention Recommendations

To prevent and reduce tobacco use among young people, The Guide to Community Preventive Services and the Centers of Disease Control and Prevention (CDC) recommend policy and program interventions in the following areas:

  • Increasing the unit price of tobacco products
  • Conducting mass media campaigns combined with other interventions
  • Promoting tobacco-free environments (e.g. school systems, community venues)
  • Restricting minor’s access to tobacco products through community mobilization when combined with additional interventions

Training and technical assistance is provided to communities and school settings across the state to help support tobacco use prevention and cessation programs.






Updated: August 12, 2019