Smoking kills more people than alcohol, AIDS, car crashes, illegal drugs, murders, and suicides combined — and thousands more die from other tobacco-related causes such as involuntary exposure to secondhand smoke, fires caused by smoking (more than 1,000 deaths/year nationwide) and smokeless tobacco use. 2022 NC SHIP, pg. 70.

• Almost half of all young people who have ever used a cigarette started with menthol
• Young people use e-cigarettes for social reasons and because they come in flavors
• 76% of youth under 21 who got their e-cigarettes from social sources got them from someone under 21
• 2 out of 3 young people who currently use e-cigarettes are seriously thinking about quitting
• 24% of young people who have never tried an e-cigarette are open to trying one in the next year

Although a majority of cigarette smokers make a quit attempt each year in the  United States, less than one-third use evidence-based methods which include FDA-approved tobacco treatment medications and behavioral counseling to support quit attempts.  Nationally, one of the largest disparities is in the behavioral health population.  2022 NC SHIP, pg. 73

• Fund comprehensive state tobacco control programs to levels recommended by the CDC
• Implement high-impact media campaigns that warn about the dangers of tobacco use
• Implement state and local tobacco-free and smoke-free air policies that include e-cigarettes
• Implement strategies to curb tobacco product advertising and marketing that are appealing to young people
• Increase access to standard-of-care tobacco use treatment
• License tobacco retailers to enforce youth access to tobacco laws
• Raise the age of tobacco product sales to 21 to comply with federal law
• Raise the price of tobacco products through a tobacco tax
• Remove state preemption of local government regulations on the sale, promotion, distribution, and display of tobacco products
• Restrict the sales of flavored tobacco products

NC State Center for Health Statistics, Behavioral Risk Factor Surveillance System (BRFSS) NC Youth Tobacco Survey, Smoke-free/Tobacco free local regulations maps

• Data regarding sale and consumption of new and emerging tobacco products
• Data to understand health disparities regarding tobacco use and exposure to hazardous secondhand smoke and e-cigarette emissions.
• Data on the effectiveness of price policies to prevent initiation of e-cigarette use among young people