Dramatic drop in teen smoking due to N.C. Health and Wellness tobacco program

Cigarette use dropped 25 percent among high school students and nearly 38 percent by middle school students from 2003 to 2005, according to the evaluation report. The decline appears strongly related to the statewide tobacco use prevention and cessation initiatives, the researchers said.

The evaluation covers the first three years of activity, from 2003 to 2005, by the Teen Tobacco Use Prevention and Cessation Initiative of the North Carolina Health and Wellness Trust Fund. The fund was established with North Carolina’s share of tobacco lawsuit settlement money. The report also discusses how the teen initiative affects teens and youth of different ages, ethnicity and socioeconomic status, what activities of the funded effort led to those effects and ways to improve outcomes in the next few years.

“Our data shows that the Health and Wellness Teen Initiative, as the first state-funded effort and one that is highly successful over the last three years, has allowed political leaders, policy-makers, parents and youth themselves to recognize and more successfully deal with the health effects of tobacco,” said Dr. Kathryn Kramer, associate director of the UNC School of Medicine’s Tobacco Prevention and Evaluation Program and a co-author of the report.

The anti-smoking program for teens has achieved several noteworthy accomplishments, the report said. These include:

• More than two-thirds of North Carolina school districts have adopted 100 percent tobacco-free school policies, up from 22 percent in 2003. Such policies prohibit tobacco use by anyone at anytime on a school campus.
• Youth awareness of the initiative’s media campaign and the serious health consequences of tobacco use increased from 45 percent in 2004 to 54 percent in 2006.
• North Carolina now ranks 21st in the U.S. in state funding for tobacco use prevention and cessation. At the start of the initiative, North Carolina ranked near the bottom of U.S. states.

The evaluation also identifies potential challenges to the program’s future success and outlines three primary recommendations for dealing with those challenges. Funding is a primary challenge: similar programs in Florida, Massachusetts and Minnesota showed early gains, but funding cuts halted and in some cases reversed program successes, according to the report.

First, the report recommends the North Carolina Health and Wellness Trust Fund take steps to solidify the program’s gains and accomplishments while resisting pressure to cut funding. “The gains would go away if program funding was cut,” Kramer said.

Second, the report recommends at least $2.5 million in new funding for central and eastern regions of the state, so these areas will receive the same spending as the western region. Per capita funding in the western region is higher, and that region has shown the most policy success, the evaluation found.

Finally, the report recommends that leaders across the state reconvene periodically to review current strategies and to consider what should be changed, stopped or added.

“The Health and Wellness Trust Funded program in North Carolina is showing great and growing success,” said Dr. Adam Goldstein, an associate professor of family medicine and director of the UNC School of Medicine’s Tobacco Prevention and Evaluation Program. “The decision to focus on tobacco-free schools in the state, and the success of that movement, is one of the greatest public health stories in North Carolina in the last decade,” he said.

Note: The report is available online at http://fammed.unc.edu/TPEP.

School of Medicine contact: Stephanie Crayton, (919) 966-2860 or scrayton@unch.unc.edu.

News Services contact: Becky Oskin, (919) 962-8596 or becky_oskin@unc.edu.

School of Public Health contact: Ramona DuBose, (919) 966-7467 or ramona_dubose@unc.edu.