Tobacco use in North Carolina 2018

Cigarette use: North Carolina*

• In 2016, 17.9 percent of adults smoked. Nationally, the rate was 17.1 percent.¹
• In 2017, 12.1 percent of high school students smoked on at least one day in the past 30 days. Nationally, the rate was 8.8 percent.²

Other tobacco product use: North Carolina

• In 2015, 2.8 percent of adults used e-cigarettes, 2.2 percent used smokeless tobacco and 2.8 percent smoked cigars.³
• In 2017, 22.1 percent of high school students used e-cigarettes on at least one day in the past 30 days. Nationally, the rate was 13.2 percent.²

Economics of tobacco use and tobacco control

• North Carolina received $450.5 million (estimated) in tobacco settlement payments and taxes in fiscal year 2018.⁴
• Of this, the state allocated $2.1 million in state funds to tobacco prevention in fiscal year 2018, just 2.1 percent of the Centers for Disease Control and Prevention’s annual spending target.⁴
• Smoking-caused health care costs: $3.81 billion per year⁴
• Smoking-caused losses in productivity: $4.24 billion per year⁵

North Carolina tobacco laws

Tobacco taxes

• North Carolina is ranked 47th in the U.S. for its cigarette tax of 45 cents per pack (enacted September 2009), compared to the national average of $1.73. (Connecticut and New York have the highest tax at $4.35 and Missouri has the lowest at 17 cents.)⁶ ⁷ ⁸
• E-cigarette products are taxed at 5 cents per fluid milliliter of consumable product. All other tobacco products are taxed at 12.8 percent of the cost price.⁶ ⁷ ⁹

Clean indoor air ordinances

• Smoking is prohibited in schools (public schools only), restaurants and bars (allowed in cigar bars).⁶ ⁷
• Smoking restrictions are required in government workplaces (prohibited in state government buildings) and childcare facilities.⁶ ⁷
• There are no smoking restrictions for private workplaces, casinos/gaming establishments (tribal casinos only), retail stores and recreational/cultural facilities.⁶ ⁷

Youth access laws

• The minimum age of sale for tobacco products in North Carolina is 18.⁷
• Establishments are required to post signs stating that sales to minors are prohibited.⁶ ⁷

Quitting statistics and benefits

• The CDC estimates that 53.8 percent of daily adult smokers in North Carolina quit smoking for one or more days in 2016.¹⁰
• In 2014, the Affordable Care Act required that Medicaid programs cover all quit medications.⁷**
• North Carolina’s state quit line invests 99 cents per smoker, compared to the national average of $2.10.⁷
• North Carolina does not have a private insurance mandate provision for quitting tobacco.⁷

Notes and references

Updated June 2018

* National and state-level prevalence numbers reflect the most recent data available. This may differ across state fact sheets.

** The seven recommended cessation medications are NRT gum, NRT patch, NRT nasal spray, NRT inhaler, NRT lozenge, Varenicline (Chantix) and Bupropion (Zyban). Fiore MC, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: US Department of Health and Human Services. Public Health Service: May 2008.

1. CDC, Behavioral Risk Factor Surveillance System, 2016.
2. CDC, Youth Risk Behavior Surveillance System, 2017.
3. CDC, State-Specific Prevalence of Tobacco Product Use Among Adults - United States, 2014-2015, MMWR.
4. Campaign for Tobacco-Free Kids, Broken Promises to Our Children: a State-by-State Look at the 1998 State Tobacco Settlement 19 Years Later FY2018, 2017.
5. Campaign for Tobacco-Free Kids, Toll of Tobacco in the United States, 2018.
6. American Lung Association, SLATI State Reports, 2017.
7. American Lung Association, State of Tobacco Control, 2018.
8. Campaign for Tobacco-Free Kids, State Cigarette Excise Tax Rates & Rankings, 2018.
9. Campaign for Tobacco-Free Kids, State Excise Tax Rates for Non-Cigarette Tobacco Products, 2018.
10. CDC, Behavioral Risk Factor Surveillance System, State Tobacco Activities Tracking and Evaluation System, 2016.