N.C. receives failing grade from American Lung Association

Christina Day

January 27, 2014

Fifty years after the first Surgeon General’s report to conclude that cigarette smoking causes lung cancer, North Carolina has received a failing grade in the 2014 State of Tobacco Control released by the American Lung Association.

The report, which grades states on “key policies that can help prevent the death and disease caused by tobacco use” gave North Carolina an “F” for each category: tobacco prevention, smoke-free air, cigarette tax and cessation coverage.

“The main concern is still the high rate of tobacco use among Ashe County residents,” David Willard Northwest Tobacco Prevention Coordinator for Appalachian District Health Department said. “Adult smoking in Ashe is reported at 24 percent, which is above both the state and national average.”

Willard said Ashe has made some progress in reducing residents’ exposure to secondhand smoke since the 2010 N.C. state law banning smoke in restaurants and bars.

“Both Ashe County and West Jefferson have passed tobacco free policies for government buildings, and Northwestern Regional Housing Authority is in the process of making all of their properties smoke-free indoors by August 2014,” Willard said.

Neither Jefferson nor Lansing has written policies restricting tobacco use, and state-wide there are no provisions that ban smoking in private workplaces, retail stores or recreational/cultural facilities.

Willard said a major factor in the high levels of tobacco usage in Ashe, and the reason for North Carolina’s failing grade in the “cigarette tax” category, is that the state ranks 45 out of 51 for highest tax per pack of 20 cigarettes.

“The national average is $1.53 per pack, with New York leading at $4.35 per pack. North Carolina, (which taxes 45 cents) is one of 18 states that remain less than $1 per pack,” Willard said.

He said studies show that two populations, young people and people of low socioeconomic status (SES), are most sensitive to cigarette excise tax increases.

When states institute an “increase in cigarette tax, the largest impact and decrease in smoking is seen at the youth level and with low SES populations,” Willard said.

Another factor for tobacco use among youth in Ashe, Willard said, is the prevalence of electronic cigarettes, often called e-cigarettes.

“The real concern with these is that they come in all flavors, which appeals to youth,” he said. “The electronic cigarette may also be seen as a gateway to begin smoking traditional cigarettes, since they still contain the addictive component of cigarettes (nicotine).”

North Carolina also recieved a failing grade when it came to tobacco prevention control and spending, but does offer a state funded program called QuitlineNC.

“QuitlineNC is the most effective source we have currently,” Willard said. “It’s 100 percent free and confidential and a person has a 55 percent greater chance of quitting with use of the Quitline.”

QuitlineNC, which can be reached at 1-800-QUIT-NOW or online at, offers free coaching, resources and two weeks free nicotine replacement therapy to uninsured tobacco users who sign up for the cessation program.

Willard said North Carolina’s failing grades do not discourage him from working towards educating people in the region on the dangers of tobacco use.

“I look at these numbers and all I want to do is make the difference. The chronic diseases driven by these factors can easily be prevented,” Willard said. “All F’s gives me much more motivation to continue to fight against tobacco use and chronic disease.”

To reach Christina Day, call 336-846-7164 or on Twitter @cdayinwj