Guest Post: High School Tobacco Use on the Rise

High School Smoking

North Carolina is moving backward in the fight against tobacco use, which continues to be the number one

cause of preventable death in our state. According to the 2013 North Carolina Youth Tobacco Survey (the 2015 

data is not yet available), cigarette use among high schoolers had declined to 13.5 percent in 2013. However, 

youth are now using other tobacco products at rising rates. Three out of every 10 North Carolina high school 

students use tobacco products and 19.1 percent of high schoolers use more than one tobacco product. Thus, it 

is imperative for our youth to be educated on the dangers of tobacco use. 


While enrolled as a high school student in Durham Public Schools I had the privilege of working as a tobacco 

prevention youth leader. I was part of a statewide network of youth advocates 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 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 tobacco use prevention funding was cut from the 

state budget.


Until 2011, the Health and Wellness Trust Fund was receiving just over $17 million a year for tobacco use 

prevention and cessation programs, which came from the approximately $137.5 million North Carolina 

receives every year as part of the Tobacco Master Settlement Agreement. However, that year, 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 by 2013.


With teen tobacco use once again on the rise, the prevention programs that were so effectively curbing teen 

tobacco use in North Carolina must be restored. By allocating just 12.8 percent of the MSA funds each year 

($17.3 million), at no cost to North Carolina taxpayers, we can once again provide an effective education 

program to youth. 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 more youth will grow up to become addicted adult smokers, and an estimated 4,370 more 

kids will die prematurely from a smoking-related disease. 


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.


Morgan Wittman Gramann is the Managing Director at the North Carolina Alliance for Health and can be 

reached at or 919.463.8329.


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