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North Carolina is not investing enough in anti-smoking efforts, according to the American Lung Association.

Cigarettes are so 20th century.

Along with rabbit ears on TV sets and rotary phones, they’re remnants of a forgotten era. We barely even see them in movies anymore.

So it may seem. Yet, though tobacco use has been greatly reduced since its heyday, and smoking is banned in most public places, it still presents a serious threat to public health — especially for younger users.

And North Carolina hasn’t been doing nearly enough about it. So says the nonprofit American Lung Association, which recently gave our state an “F” in its annual State of Tobacco Control report, as BH Media’s Richard Craver reported last week. In funding for state tobacco prevention programs; strength of smokefree workplace laws; level of state tobacco taxes, coverage; and access to services to quit tobacco and minimum age of sale for tobacco products, North Carolina falls short. The state slipped from 42nd to 44th nationally in what it spends annually on anti-smoking programs — programs that we know work.

The resources are available. North Carolina gained $455.7 million from tobacco excise taxes and its share of the 1998 Master Settlement Agreement in fiscal 2018-19, but spent only $2.2 million on tobacco-prevention initiatives. That’s about 2.2% of the amount recommended by the Centers for Disease Control and Prevention.

Much of the money originally intended for anti-smoking efforts has been diverted toward unrelated causes. In 2011, the legislature abolished the N.C. Health and Wellness Fund — financed with settlement dollars — as part of an attempt to close a state budget gap. That money was never restored. In addition, North Carolina has one of the lowest excise tax rates for cigarettes in the country, 45 cents, negating a powerful smoking disincentive.

Some efforts have been made toward improvement. N.C. Rep. Donny Lambeth (R-Forsyth) has co-sponsored a bill to provide $17 million in each of the next two years for initiatives to prevent young people from using tobacco products. But that bill has gone nowhere since it was filed in April.

On Dec. 20, President Trump signed a new federal law restricting the use of all tobacco products to those over age 21. That certainly will help. But more needs to be done.

Certainly, we’re sympathetic to the plight of farmers who have relied on tobacco as a cash crop for generations. But that concern is outweighed by the risks associated with tobacco products — cancer, heart disease and emphysema among them — that are costly and deadly. The risks are harmful both to smokers and to those exposed to secondhand smoke. Nicotine is still as addictive as before, even in the smaller quantities produced by vaping. And young people are still at risk: Despite a continued decline in traditional cigarette use, e-cigarette use among high school students increased 78% between 2011 and 2017 and 48.5% among middle-school students, according to the CDC.

“With the youth vaping epidemic still rising, we may have lost an opportunity to make the current generation of kids the first tobacco-free generation,” said June Deen, the ALA’s director of advocacy.

This is not the path to a prosperous and healthy future. State lawmakers need to change course on this issue. Now.

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