The "Story Behind the Curve" helps us understand why the data on youth tobacco/nicotine use is the way that it is in our community. When we understand the root causes of our community problems, we have a better chance of finding the right solutions, together

What's Helping? These are the positive forces at work in our community and beyond that influence this issue in our community.

• Work to reduce access and availability of tobacco/nicotine and other substances among youth, including education for parents and families. Federal policies that limit access to tobacco products until age 21.
• General decline of smoking and smokeless tobacco products among younger age cohorts.

What's Hurting? These are the negative forces at work in our community and beyond that influence this issue in our community.

• Social acceptance of tobacco/nicotine use among some groups.
• Access to tobacco/nicotine products from friends and family. No state law restricting access to tobacco/nicotine products until age 21, which limits law enforcement ability to address sales to young adults ages 18-21.
• Barriers for youth to access nictotine replacement and therapy for nicotine addiction. Reluctance to accept opportunities and services from "outsiders" and a preference to rely on own self and kin network for support.
• Social, economic, and environmental factors that increase risk of substance use, such as poverty, unemployment and underemployment, homelessness and housing concerns (including cost and substandard conditions). Lived experiences such as violence, trauma, and adverse childhood experiences (ACEs). Connections between mental health concerns and substance use.
• Underlying factors such as COVID-related social disruption, social media influences, decreased social cohesion and increased divisiveness, and impaired family support.