Updated 3/21/2024

2023-2024 Priorities:​​​​​​​

• Raise the state minimum sales age of tobacco products from 18 to 21 and establish a tobacco retailer permitting system to protect NC young people.
• Ensure that all Medicaid and Uninsured populations have barrier-free access to evidence-based, standard of care tobacco treatment which includes coaching/ counseling and FDA approved medications.
• Implement state and local tobacco-free and smoke-free air policies; continue to monitor and track progress and promote quality, effective implementation.
• Promote increased and recurring appropriations for robust and evidence-based tobacco prevention and cessation programs and services.

• Explore seeking reimbursement for Certified Tobacco Treatment Specialists (CTTS) for their work in providing standard of care tobacco treatment, including counseling and access to FDA approved tobacco treatment medications under the supervision of a prescriber.
• Recommend an electronic cigarette policy for restaurants and bars.
• Increase the price of tobacco products by raising the current state tax on cigarettes and increase other tobacco product taxes to parallel levels.

2023-2024 SHIP Tobacco Committee Meeting Schedule:

• Thursday, October 12, 2023, from 12:30 to 2:00 pm, Microsoft Teams
• Thursday, December 21, 2023, from 12:30 to 2:00 pm, Microsoft Teams
• Thursday, February 8, 2024, from 12:30 to 2:00 pm, Microsoft Teams
• Thursday, April 11, 2024, from 12:30 to 2:00 pm, Microsoft Teams
• Thursday, June 13, 2024, from 12:30 to 2:00 pm, Microsoft Teams

Thursday, April 11, 2024, from 12:30 to 2:00 pm, Microsoft Teams- Work Group Meeting

Attendees: Sarah Arthur, Nnenne M. Asi, Alana Denise Austin, Teresa Beardsley, John Broome, Anna Bess Brown, Kim Canady, Georgia Childs, Ashley Curtice, Kaycee Deen, Krysta Gougler-Reeves, Sanquis Graham, Jen Greene, Elizabeth Halstead, Shayla Hayes, Courtney Heck, Sally Herndon, Scott Herrick, Kathryn Higdon, Mona Hood, Kearston Ingraham, Kristin Jimison, Rita Krosner, Jeffrey LaForge, Robyn Lane, Tobin Lee, Lu McCraw, C. Michelle Mulvihill, Sherrie Parish, Kathryn Polaskey, Leah M. Ranney, Ray Riordan, Delton Russell, LaKeisha Scott, Penny Shelton, Kyle Smith, Gregg M. Stave, Deidre Sully, Erin Sutfin, Joyce Swetlick, Natalie Thompson, Tenika Walker, Mary H. Ward, David Willard, Megan S. Williams, Mary Williams-Stover, Juliana Wilson

• Welcome, Introductions, and Icebreaker in the Chat        
  • Sally Herndon, Delton Russell, and Jen Greene, the co-leaders,  welcomed everyone.
  • Everyone present was asked to share in the chat their name, agency, and if there was one thing they would be famous for outside of work, what that would be.                               
• Policy Priority Updates
  • Brief updates on the Short Session
    • YTS (Youth Tobacco Survey) exemption
      • The special provision for the North Carolina Youth Tobacco Survey (YTS) to be exempt from the Parents bill of rights requirement to have parents opt in for their child to participate is proposed as a technical correction for the Short Session.
      • The Youth Tobacco Survey (YTS) is the only survey that provides North Carolina specific data.
      • The Youth Risk Behavior Survey (YRBS) and the National Youth Tobacco Survey already received special provisions for exemption to the Parents’ Bill of Rights.
  • Compliance with Federal T21 law
  • The Short Session is too short to for a policy this complex. 
  • Additional guidance from SAMHSA (Substance Abuse and Mental Health Services Administration) has not been received yet and is still needed to make an informed decision.
  • An interagency work group has been working on this for several years and has good bill language from the government perspective.
  • This work will be moved to the next long session. There continues to be local support from boards of health, county commissioners, and schools.
• Calling on Partners!  NCALHDs, ALA, ACS, AHA, NCAH, NCPHA, CDC Health Disparities Grant/Tobacco, Duke-UNC TTS, others?
  • Sally Herndon shared the NC Division of Public Health received a no cost extension on their CDC Health Disparities grant. The following two projects on building trust and filling data gaps will be continue:
    • The LGBTQ+ survey focuses on tobacco use and other health areas of interest in the LGBTQ+ communities.
    • The North Carolina Native American Tobacco Survey will fill some data gaps about tobacco use in tribes through pow wows and other cultural events. This survey is being done in partnership with is in partnership with the North Carolina Commission on Indian Affairs and Wake Forest Baptist.
    • The Tobacco Prevention and Control Branch is also working with the Commission on Indian Affairs to consider how to use some of the JUUL settlement funds to reach youth in tribes.
  • Sally Herndon shared the Duke-UNC Tobacco Treatment Specialist Training (Duke-UNC TTS) Program offers comprehensive and intensive short courses on pharmacotherapy, counseling, youth/ young adult one day trainings, blogs, and more. There are some scholarships available for clinicians and public health practitioners who are serving are serving low income, rural, and/or historically marginalized populations.
  • Jen Greene, Health Director, AppHealthCare, shared the North Carolina Association of Local Health Directors (NCALHDs) has not finalized what they will be focusing on during this short session. Tobacco 21 continues to be a priority and is an important focus that continues to be on their radar.
  • Scott Herrick, North Carolina State Government Relations Director at American Heart Association (AHA), shared AHA continues to be active with their campaigns for cardiac emergency response plans in schools and telephone CPR. AHA is reviewing the 2019 legislation that passed to determine if it is comprehensive enough and if any further amending is needed. They will also be talking with those doing the Duke race car studies, to ensure they are not conflicting with what they are doing going forward.
  • There were no updates from the North Carolina Alliance for Health (NCAH).
  • Deidre Sully, Regional Manager for Region 7 (Johnston, Nash, Wake, Warren, Granville, Vance, and Franklin counties), shared she has been working with county boards of health on resolutions for Tobacco 21 (T21). Since January, Franklin, Granville, Vance, and Warren counties passed T21 resolutions.
  • Jeffrey LaForge, Manager, Care Management, Carolina Complete Health (CCH), shared CCH has added smoking cessation to their HPRs and with increased focus on smoking cessation, vaping, and tobacco use overall. They will be doing thorough assessments and directing them to tobacco cessation resources.
  • Kearston Ingraham, Research Program Evaluator, Duke Cancer Institute, shared the National Institute of Environmental Health Sciences is hosting their 10th Annual Women’s Health Awareness event. Duke Cancer Institute sponsors cancer tract activities, including cancer screenings. Last year they incorporated the lung cancer risk assessments into their screening program, as well as a need for appropriate referrals.
• Medicaid Tobacco Free Policy: Updates on BreatheEasyNC and Change for Life
  • An updated Medicaid Policy Bulletin clarified questions stakeholders had, specifically those that are not subject to the full comprehensive policy.
  • A frequently asked questions resource is being developed and a model draft policy is available on the Breathe Easy NC website.
  • From the latest SAMSHA data, 30% of the positive change in tobacco-free policies in the nation in the last few years has come from North Carolina.
  • The Medicaid tobacco-free policy goes into effect on July 1, 2024.
  • The Division of Public Health is at the table to help bring about compliance over the next year. The regional managers and local coordinators are working across the state.
  • The Change for Life Committee is an opportunity for peer-to-peer learning. Sign up is available on the Breathe Easy NC website at https://breatheeasync.org/.
• NC Medicaid Proposal to Expand Access to Tobacco Treatment in Partnership with Pharmacies: A Kitchen Table Conversation: 
  • The panelists included the following people. Highlights from the panel are included below.
    • Joyce Swetlick, Director of Tobacco Cessation, TPC Branch with
    • Penny Shelton, Executive Director NC Association of Pharmacists
    • Kimberly Canady, RN, Nurse Consultant II, NC Medicaid, Clinical Policy
  • In 2021, state law 2021-110 was passed by the General Assembly and signed into law by Governor Cooper. Pharmacists in North Carolina were authorized to provide nicotine replacement therapy (NRT) without patients having to go to a medical provider to get a prescription before going to the pharmacy.
  • The authority is for pharmacists to be able to provide NRT. The protocol is the method by which the pharmacist is able to provide a prescription.
  • Medicaid beneficiaries are required to have a prescription to have the NRT covered by Medicaid. The protocol is needed mainly for Medicaid beneficiaries. NRT is available over the counter. If the insurance provider requires a prescription, the protocol could be used by pharmacists to provide a prescription and submit a claim.
  • The protocol does not guarantee payment. The counseling must be connected to the protocol so the pharmacist can be paid for the time that they are educating the individual about the NRT and how to use it. 
  • The NRT protocol does have a provision to allow for individuals less than the age of 18 to be able to receive care under this protocol with parent or legal guardian permission. The pharmacist would provide a consent form for the parent or legal guardian.
  • Part of the protocol is patient education and support, however, the codes in the protocol, 99202 and 99212, are not counseling codes. For there to be comprehensive patient education and support may also have to depend on the Quitline for a referral.
  • The benefits of the protocol are that it adds additional access to care by adding another avenue of contact with a healthcare provider to assist with tobacco cessation.
  • The main limitation is how the protocol is rolled out and how to approach this comprehensively. Medicaid has chosen to roll this out tied to the protocol.
  • Additional information on submitting requests for coverage is available on Medicaid’s website at https://medicaid.ncdhhs.gov/providers/forms/providerstakeholder-request-coverage-form.  
  • The North Carolina Association of Pharmacists offers training programs for pharmacists; however, tobacco cessation does not have a statute required training. This makes data and tracking difficult.
• Future Planning, Announcements and Wrap Up
  • Recommendations for breakout groups on specific topics of interest and/or topics for the larger group can be shared with Sally Herndon, Delton Russell, Jen Greene, and/or Ashley Rink.
  • Sally Herndon shared an idea for doing a test run with this group on a workshop series on what North Carolina is doing with Juul Settlement Funds.
  • North Carolina is the first state to set up a documents depository related to the lawsuit against JUUL through a contract with the UNC library system. The documents are being organized and filed by UCSF because they are the library of record for the Tobacco Master Settlement Agreement.
  • The next SHIP Tobacco Committee meeting will be on Thursday, June 13, 2024, from 12:30 to 2:00 pm, from 12:30 to 2:00 pm via Microsoft Teams. The next meeting will feature prevention media strategies in partnership with the Rescue Agency.
  • Announcements:
    • Mary Williams-Stover shared the Center for Black Health and Equity is hosting their 10th Annual No Menthol Sunday on May 19, 2024. Additional information is available at https://www.nomentholsunday.org/.
    • Joyce Swetlick shared the Quitline has implemented a menthol portion to their program. Anyone who is identified as using a menthol product will receive extra information and counseling regarding menthol and starting in July will receive up to 12 weeks of combination nicotine replacement therapy.

Thursday, February 8, 2024, from 12:30 to 2:00 pm, Microsoft Teams- Work Group Meeting

Attendees: Sarah Arthur, Nnenne Asi, Joshua Batten, Kim Bayha, Teresa Beardsley, Ronny Bell, Lorraine Bolduc, Lani Callison, Kim Canady, Carleen Crawford, Ashley Curtice, Ronda Doward, Stephanie Gans, Elizabeth Halstead, Courtney Heck, Sally Herndon, Mona Hood, Rodney Jenkins, Amy Jones, Jeffrey LaForge, Robyn Lane, Danya MacDonald, Jim Martin, Erin McClain, Molly Monath, Tamra Morris, Michelle Mulvihill, Tiffany Munday, Sharon Nelson, Dana Painter, Sherrie Parish, Vera Reinstein, Ray Riordan, Delton Russell, Charlene Sampson, LaKeisha Scott, Jasmine Simmons, Lou Ann Simmons, Les Spell, Gregg Stave, Deidre Sully, Erin Sutfin, Joyce Swetlick, Natalie Thompson, Mary Ward, David Willard, Megan Williams, Mary Williams-Stover, Juliana Wilson, Rachel Yip, Christine Zazzaro; Staff: Ashley Rink

• Welcome, Introductions and Icebreaker in the Chat
  • Sally Herndon and Delton Russell welcomed everyone.
  • Everyone present was asked to share in the chat their name, agency, and what brought them feelings and thoughts of nostalgia.
• State of Tobacco Control Report, American Lung Association
  • Danna Thompson was unable to attend the meeting to present on the American Lung Association’s State of Tobacco Control Report due to a family emergency.
  • The 2024 State of Tobacco Control North Carolina report is available at https://www.lung.org/research/sotc/state-grades/north-carolina.
  • The report includes recommendations for actions to be taken by North Carolina's elected officials to reduce tobacco use and exposure to secondhand smoke.
  • Thoughts and questions shared about the 2024 report were:
    • Medicaid does not cover group therapy.
    • Even with Medicaid Expansion, in North Carolina there is still a co-pay for preventative medications, like tobacco cessation medications, for people over the age of 21.
    • Need for opportunities for pediatricians to be able to bill Medicaid for counseling parents during a well visit around cessation and not only sick visits.
    • The criteria for the report are based on what CDC recommends as best practices. 
• Policy Priority Updates
  • Jim Martin, Director of Policy and Programs with the Tobacco Prevention and Control Branch, shared 42 states have passed laws to increase their age from 18 to 21. There are many areas within North Carolina’s statutory language  that need to be strengthened to effectively reduce tobacco sales to minors.
  • Ronda Doward, Director of Tobacco Prevention with the Division of Mental Health Developmental Disabilities, and Substance Use Services, shared updates from the Annual Synar Report related to retail violation rate of sales to minors. Underage purchasers are used that are between the ages of 16 and 17.
  • Ronda shared additional guidance is anticipated from SAMHSA (Substance Abuse and Mental Health Services Administration) for the eight states that do not have a Tobacco 21 law by December 2024. The state may be in jeopardy of losing 10% of block grant dollars that are received for prevention and treatment services (about $5.4 million dollars) if the state’s retail violation rate is over 20%. The current rate is 21.9%.
  • Ronda also shared there was a high retail violation rate with vape shops in a pilot study in 10 counties with a sample size of about 400 inspections; 16- and 17-year-olds were used for those samples.
  • Sally Herndon shared over 50 resolutions supporting an effective Tobacco 21 law have been received from local health departments, boards of health, county commissioners, and school boards. At the local level there has been movement within municipalities addressing vape shops through zoning regulations.
• Updates on Medicaid Tobacco-free Policy and Cessation Work
  • Steph Gans, Tobacco Treatment Specialist with the Tobacco Prevention and Control Branch, shared highlights of progress with BreatheEasyNC Becoming Tobacco Free
    • The acceleration of the decrease among people struggling with their mental health or substance use coincides with the work of BreatheEasyNC.
    • There has been an increase in offering screening for tobacco use.
    • There have been increases in smoking cessation, counseling, nicotine replacement therapy, and non-nicotine medications.
    • There have been significant increases in smoke-free campuses; the acceleration is related to BreatheEasyNC and Change for Life Tobacco Free Recovery Coalition bringing evidence-based standard of care into different types of behavioral facilities.
    • The Change for Life Tobacco Free Recovery Collaborative has expanded statewide with over 60 organizations participating. This provides a space for peer organizations to be able to mentor each other in all things related to being and becoming tobacco free.
    • NC Medicaid is working on pharmacist reimbursement since pharmacists can dispense nicotine replacement therapy from the pharmacy without a doctor’s visit.
    • For additional information refer to Steph’s slide deck titled “NC BENC progress.”
  • An amendment has been sent to the tailored and standard plans to move the tobacco free policy requirement to July 1. The requirement affects all North Carolina Medicaid managed care, long term services and support providers (LTSS providers); their staff are prohibited from tobacco use while on the provider grounds, in their buildings, and in their vehicles.
    • A new bulletin will be released with the new date for tobacco free policy requirement.
    • Ray Riordan shared the regional tobacco control managers will be starting an early adopter pilot project for LTSS providers. The regional managers will be conducting listening sessions to identify provider staff concerns to assist with planning and implementation processes for the new tobacco free policy. There will be offerings of training, technical assistance, tobacco free signage, and free nicotine replacement therapy to staff at these early adopter pilot project sites.
• Partner Updates, Announcements and Wrap Up  
  • The next SHIP Tobacco Committee meeting will be on Thursday, April 11, 2024, from 12:30 to 2:00 pm via Microsoft Teams.
  • Vera Reinstein shared Alliance Health has contracted with the North Carolina Association of Pharmacists to help study, pilot, and educate pharmacies on ways that they can support the behavioral health population and how to pay for that. The North Carolina Association of Pharmacists is coming up with a pharmacy locator to find participating pharmacies.
  • Natalie Thompson shared about conversations happening around conversations around UDOs and zoning. She has met with Durham County City Planning Department. Unified Development Ordinance (UDO) includes a collection of zoning regulations and ordinances that counties and or cities may adopt to organize all their rules around zoning.
  • Kim Bayha shared in Mecklenburg they have been working on building the foundation and recruiting to launch a multicultural tobacco free coalition. About thirty people attended an in-person interest meeting. They are partnering with the Center for Black Health and Equity and anticipate launching in April 2024.
  • The following topics were shared for consideration for future meetings:
    • Work being done with JUUL settlement funds
    • Tips from Former Smokers Campaign
    • American Indian Tobacco Survey- Ronny Bell
    • Addressing vape shops through zoning regulations
    • Awareness around menthol

Thursday, December 21, 2023, from 12:30 to 2:00 pm, Microsoft Teams- Work Group Meeting

Attendees: Sarah Arthur, Teresa Beardsley, Ann Boonn, John Broome, Anna Bess Brown, Lani Callison , Kim Canady     , Carleen Crawford, Ashley Curtice, Lisa Dalton, Kaycee Deen, Ronda Doward, Sanquis Graham, Sharon Greer, Doreen Harris, Sally Herndon, Shamika Howell, Kearston Ingraham, Kristin Jimison, Jeffrey LaForge, Noxxie Malinga, Jim Martin, Viviana Martinez, Lu McCraw, Beth McDermott, Kimberly McDonald, Molly Monath, Michelle Mulvihill, Sherrie Parish, Richard Peters, Marina Pieretti, Marisa Ramos, Vera Reinstein, Ray Riordan, Delton Russell, Charlene Sampson, Jasmine Simmons, Lou Ann Simmons, Kyle Smith, Ann Staples, Gregg Stave, Deidre Sully, Joyce Swetlick, Danna Thompson, Natalie Thompson, Mary Ward, Marianne Hedrick Weant, David Willard, Mary Williams-Stover, Juliana Wilson; Staff: Hannah McDiarmid and Ashley Rink

• Welcome, Introductions and Icebreaker in the Chat                                                       
  • Sally Herndon welcomed everyone and shared the Surgeon General Vivek Murthy invited the nation to build and strengthen our relationships, both personal and professional, as there is growing evidence that these connections keep us healthy. Everyone present was asked to share in the chat their name, agency, and what connections they will make over the winter holidays.
• Priority Settings of this Committee and Key Stakeholders 
  • Survey Results – This Committee
    • Ashley Rink, Program Manager with the NC SHIP Community Council, reviewed the results of the SHIP Tobacco Committee Priority Setting 2023-24 Survey.
  • Priority Setting Complete for 2024 – NCAH
    • Marianne Hedrick Weant, Program Manager with North Carolina Alliance for Health (NCAH), shared policy wins and 2024 policy priorities and goals. Additional information about their priorities is available at https://www.ncallianceforhealth.org/tobacco-use-prevention/.
    • For additional information and/or to become involved with NCAH visit their website at https://www.ncallianceforhealth.org/.
  • Priority Setting in Process – NCALHDs
    • Sally Herndon shared the North Carolina Association of Local Health Directors’ (NCALHDs) priority setting process was currently underway and was not finished as of the meeting.
    • NCALHD has had Tobacco 21 on their priority list in the past. Many health directors are passing resolutions about an effective Tobacco 21 law.
  • Priority Setting in Process – Tobacco Prevention and Control in DPH/DHHS
    • Jim Martin, Director of Policy and Programs with the Tobacco Prevention and Control Branch, shared updates on special provisions and Tobacco 21.
      • Special Provision to exempt NC YTS survey from Parents bill of rights requirement to have parents opt in for their child to participate
      • Special Provision to allow TPC Branch to continue serving the young adult population with Juul Settlement funds programs and services
      • T21 – building support/possible incremental steps without closing doors on future progress 
    • Others? 
      • The American Lung Association is in line with the priorities that had been shared and would like to support them. There are opportunities to connect with champions and work together across the state. 
      • There may be opportunities to align the work with Breathe Easy North Carolina and Change for Life with the Opioid Settlement work that is occurring throughout the state.
      • The Justus-Warren Heart Disease and Stroke Prevention Task Force’s action agenda supports tobacco cessation and tobacco use prevention. Additional information and their action agenda is available at https://www.startwithyourheart.com/.
• Brief Updates on Youth Access to Tobacco in NC Data from DMH/DD/SAS
  • Ronda Doward, Director of Tobacco Prevention with the Division of Mental Health Developmental Disabilities, and Substance Use Services, reviewed the unofficial results of the Annual Synar Report. The report is available at https://www.ncdhhs.gov/divisions/mental-health-developmental-disabilities-and-substance-use-services/reports/annual-synar-report.
  • The Synar survey is done annually to demonstrate compliance in North Carolina. The unofficial retail violation rate was 21.9% due partly because of a decline in the number of retailers able to be counted in the survey sample design. Reasons retailers were not included they were not selling tobacco products, out of business, or were not located. The sample included a total of 549 retailers. In previous years, the violation rate was under 20%.
  • The report will become official once SAMHSA (Substance Abuse and Mental Health Services Administration) approves the report.
• Overview - Updated Research on the Impact of Tobacco Control Policies on Convenience Stores
  • Ann Boonn, Director, Research, Campaign for Tobacco-Free Kids, provided an overview of a research report released in October 2023 on the alliance between big tobacco and convenience stores. Additional information is available at https://www.tobaccofreekids.org/what-we-do/industry-watch/deadly-alliance.
  • The tobacco industry invests heavily at the point-of-sale. The objective of point-of-sale marketing is to promote price and place tobacco products that are appealing to consumers and boost sales. Price discounts make up about 99% of the tobacco marketing at the point of sale and 97% of marketing spending. Research shows tobacco marketing works and more exposure to tobacco marketing translates to more tobacco use.
  • At the national level, corrective statements at the point of sale went into effect. The signs must be displayed from now until the of June 2025. The Department of Justice has set up a portal  to report stores suspected of not complying with the federal court order requiring certain stores to display signs containing corrective statements.
• Partner Updates, Announcements and Wrap Up
  • The next SHIP Tobacco Committee meeting will be on Thursday, February 8, 2024, from 12:30 to 2:00 pm via Microsoft Teams.
  • Danna Thompson, American Lung Association, shared their State of Tobacco Control report will be coming out on January 24, 2024. This may be a topic for the SHIP Tobacco Committee’s February meeting.
  • Kearston Ingraham, Duke Cancer Institute, shared the MaryAnn Black Health Equity Symposium will be on Friday, February 9, 2024, from 3:00 to 6:30 pm. The event will be in-person. Registration is open at https://www.eventbrite.com/e/maryann-black-health-equity-symposium-2024-tickets-704872120487?aff=oddtdtcreator. The keynote may be recorded and information from the abstracts and posters will be shared after the symposium.
  • The North Carolina General Assembly 2024 Short Session is scheduled to begin late April and expected to last until the end of June.
  • Sally Herndon shared a new  Medicaid Expansion Dashboard tracking the number of people enrolled is now available at https://medicaid.ncdhhs.gov/reports/medicaid-expansion-dashboard.

Thursday, October 12, 2023, from 12:30 to 2:00 pm, Microsoft Teams- Work Group Meeting

Attendees: Peter Adamowsky, Alana Austin, Kim Bayha, Terri Bell, Stella Blankenship, Lani Callison, Megan Canady, Carleen Crawford, Lisa Dalton, Kaycee Deen, Stephanie Gans, Sanquis Graham, Morgan Wittman Gramann, Jen Greene, Sally Herndon, Mona Hood, Sarah Jacobson, Amy Jones, Jeffrey LaForge, Robyn Lane, Tobin Lee, Danya MacDonald, Jim D. Martin, Erin McClain, Kimberly McDonald, Al Milak, Molly Monath, Tamra Morris, Michelle Mulvihill, Tiffany Munday, Dana Painter, Sherrie Parish, Richard Peters, Vera Reinstein, Ray Riordan, Delton Russell, Charlene Sampson, Jasmine Simmons, Lou Ann Simmons, Les Spell, Gregg Stave, Deidre Sully, Erin Sutfin, Joyce Swetlick, Tiffany Thigpen, Natalie Thompson, Tenika Walker, Mary Ward, Ernest Watts, Tori Whitley, David Willard; Staff: Hannah McDiarmid and Ashley Rink

• Welcome, Introductions, and Icebreaker in the Chat         
  • The 2023-2024 SHIP Tobacco Committee Co-leaders are Delton Russell is the Community Co-Lead, Jen Greene is the Organization Co-Lead, and Sally Herndon is the NCDHHS Co-Lead.
  • Everyone present was asked to share in the chat their name, title, organization, and favorite thing about fall.
• North Carolina General Assembly Budget Update & Impacts on Tobacco Control Landscape in NC, including but not limited to:  
  • JUUL Funding
    • For the JUUL funding, 11.25 million dollars was appropriated for each year of the biennium for commercial tobacco use prevention programming.
    • The JUUL funding is ending; there will be a need to seek additional funding from the General Assembly for continuity of those programs.
    • The 11.25 million dollars goes into a special fund that is overseen by the Tobacco Prevention and Control Branch. Of the 11.25 million dollars, $750,000 goes towards evaluation and the remainder of the dollars would be targeted to fourth through twelfth graders.
  • Parents Bill of Rights
    • There was a restriction pertaining to the administration of surveys in North Carolina, previously Senate Bill 49. With the new law, all children would be opted out unless their  parents specifically opted them into taking those surveys.
    • There has been successful work with the General Assembly to exempt the National Youth Tobacco Survey. Additional work is being done for an exception for the state surveys as well.
    • The North Carolina Youth Tobacco Survey is on hold this fall until the language is changed.
  • Other Changes
    • The method of taxing snuff and added alternative nicotine products was changed from being cost-based to weight-based. This is problematic for the parity of taxing tobacco products; snuff is a very light product, and the tax would be significantly smaller when based on weight. This change will have an impact on revenue and reduce revenue in North Carolina.
    • Increasing the price of tobacco products is an evidence-based way to prevent use. For every 10% increase in the price of cigarettes and other tobacco products there is about a 7% reduction in youth tobacco consumption and 4% reduction in adult tobacco consumption.
  • North Carolina General Assembly Budget
    • North Carolina’s budget was approved at the beginning of October. A technical corrections bill has not been confirmed at this point. The Division of Public Health has been working on several technical corrections to put forward to the General Assembly.
• Review Priorities and Feedback from Survey
  • The priority setting survey responses and comments were reviewed and discussed. There were 19 responses submitted before the meeting. Refer to the slide deck for the results reviewed and additional responses discussed on pages 4 to 12.
  • The Co-Leaders shared that the priority setting survey would remain open until Friday, October 20, 2023. 
• Potential topics shared for future meetings included:
  • Sample resolutions for decision makers in communities- Jen Greene can share a sample resolution.
  • Research from Deadly Alliance: How Big Tobacco and Convenience Stores Partner to Hook Kids and Fight Life-Saving Policies
  • The work being done with Fort Liberty.
  • Ideas for topics can be shared with Sally Herndon, Delton Russell, Jen Greene, and/or Ashley Rink.

• American Lung Association- 2024 State of Tobacco Control- North Carolina: https://www.lung.org/research/sotc/state-grades/north-carolina
• Annual Synar Report: https://www.ncdhhs.gov/divisions/mental-health-developmental-disabilities-and-substance-use-services/reports/annual-synar-report
• Tips from Former Smokers Campaign: https://www.cdc.gov/tobacco/campaign/tips/index.html
• Tobacco 21: Law of the Land: https://tobacco21.org/
• To sign up for the Ripple Effect, email Ashley Curtice at ashley.curtice@dhhs.nc.gov.
• Davis J, Clark S, et al. Comparison of Virtual and In-Person Tobacco Treatment Specialist Training. Telehealth and Medicine Today. 2023; 8(432). doi: https://doi.org/10.30953/thmt.v8.432
• Tanz LJ, Heck C, Herzig CTA, et al. Assessment of School Staff Knowledge and Perceptions of Student E-cigarette Use and Resource Needs, and E-cigarettes Confiscated at 12 North Carolina High Schools — 2019. North Carolina Medical Journal. 2023;84(6). doi:10.18043/001c.83954 

• American Cancer Society- Nicotine Replacement Therapy to Help You Quit Tobacco (2021): https://www.cancer.org/cancer/risk-prevention/tobacco/guide-quitting-smoking/nicotine-replacement-therapy.html
• American Lung Association- Smokefree Policies in Multi-Unit Housing (2022): https://www.lung.org/policy-advocacy/tobacco/smokefree-environments/multi-unit-housing
• American Lung Association State of Tobacco Control- North Carolina Highlights (2023): https://www.lung.org/research/sotc/state-grades/highlights/north-carolina
• Campaign for Tobacco-Free Kids- New Revenues, Public Health Benefits, & Cost Savings from a $1.00 Cigarette Tax Increase in North Carolina (2020). https://tobaccopreventionandcontrol.dph.ncdhhs.gov/youth/Documents/NC-TaxIncreaseBenefits.pdf
• Centers for Disease Control and Prevention- Best Practices for Comprehensive Tobacco Control Programs (2014): https://www.cdc.gov/tobacco/stateandcommunity/guides/pdfs/2014/comprehensive.pdf
• Centers for Disease Control and Prevention- North Carolina: Improving Access to Medicaid Tobacco Cessation Benefits (2022): https://www.cdc.gov/sixeighteen/state-collaborations/nc-medicaid-tobacco-cessation/north-carolina_-improving-access-to-medicaid-tobacco-cessation-benefits.pdf
• Centers for Disease Control and Prevention- Secondhand Smoke (2022): https://www.cdc.gov/tobacco/secondhand-smoke/
• Centers for Disease Control and Prevention- Smoking Cessation- The Role of Healthcare Professionals and Health Systems (2020): https://www.cdc.gov/tobacco/sgr/2020-smoking-cessation/fact-sheets/healthcare-professionals-health-systems/
• Centers for Disease Control and Prevention- STATE System Preemption Fact Sheet (2023): https://www.cdc.gov/statesystem/factsheets/preemption/Preemption.html
• Centers for Disease Control and Prevention- Tobacco 21: Policy Evaluation for Comprehensive Tobacco Control Programs. https://www.cdc.gov/tobacco/stateandcommunity/tobacco-control/pdfs/t21-policy-evaluation-guide-508.pdf
• Counter Tools- Licensing, Zoning, and Retailer Density (2023): https://countertobacco.org/policy/licensing-and-zoning/
• NCDHHS- North Carolina Standard Plan, Tailored Plan and LME/MCO Tobacco-Free Policy Requirement (2023): https://medicaid.ncdhhs.gov/blog/2023/03/15/north-carolina-standard-plan-tailored-plan-and-lmemco-tobacco-free-policy-requirement
• North Carolina Department of Health and Human Services, Tobacco Prevention and Control Branch- Sample Resolution- Protecting Our Kids from Vaping and Nicotine Addiction (September 26, 2022) North Carolina Medical Journal- Advancing Commercial Tobacco Control and Health Equity Through Policy, Systems, and Environmental Change (2022): https://ncmedicaljournal.com/article/55430
• QuitlineNC- Tobacco Treatment Standard of Care: https://quitlinenc.dph.ncdhhs.gov/health-professionals/tobacco-treatment-standard-of-care.html
• Truth Initiative- Tobacco & Pharmacies Report (2019): https://truthinitiative.org/research-resources/tobacco-industry-marketing/action-needed-tobacco-and-pharmacies
• Truth Initiative- Vaping in the Workplace (2021): https://truthinitiative.org/research-resources/emerging-tobacco-products/vaping-workplace