Tobacco & Vaping 101: North Carolina

Current Adult Smoking Rates

According to data from the Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance Survey (BRFSS), smoking rates continue to decline in the Tarheel State.[i]

In 2020, 16.5 percent of adults were classified as current smokers, amounting to 1.4 million adults.[ii] This is a 10.8 percent decrease from 2019 when 18.5 percent of adults were current smokers. Further, this is a 36.3 percent decrease from 1995 when 25.9 percent of North Carolina adults reported smoking and the first year the BRFSS started collecting data on smoking rates.

In 2020, among adults, 12.6 percent reported smoking every day, four percent reported smoking some days, 23.8 percent reported being a former smoker, and 59.7 percent had never smoked. Daily smoking rates have decreased by 2.3 percent since 2019, and by 45.2 percent since 1995. Moreover, never-smokers increased by four percent between 2019 and 2020, and by 15.7 percent between 1995 and 2020.

Lower Income Persons More Likely to Smoke

Among current adult smokers in North Carolina, in 2020, 35.4 percent reported annual incomes of less than $15,000 and 25 percent of current smokers reported earning between $15,000 and $24,999 per year. In fact, nearly two-thirds (60.4 percent) of all current adult smokers earned less than $24,999 per year in 2020. Only 10.2 percent of current adult smokers in North Carolina reported earning $50,000 or more a year in 2020.

Interestingly, smoking rates have declined more rapidly among higher income persons in the Tarheel State than their low-income counterparts. Between 1995 and 2020, smoking rates among current smokers earning $24,999 or less increased by four percent. Conversely, among persons earning $50,000 or more, rates decreased by 49.5 percent during the same period. In fact, between 2019 and 2020, smoking rates remained the same rate among low-income earners, yet decreased by 28.2 percent among higher income smokers.

Adult Vaping Rates

Despite providing annual data on cigarette and smokeless tobacco use, the CDC’s BRFSS only reports on adult e-cigarette use for 2016 and 2017.

In 2017, according to the BRFSS, 4.6 percent of North Carolina adults were current e-cigarette users. Similar to income status among smokers, lower income persons are more likely to use vapor products. In 2017, among current adult e-cigarette users, eight percent reported household incomes of $25,000 or less per year. Conversely, only 3.5 percent reported earning $50,000 a year or more.

Economic Impact of Vaping in North Carolina

In 2021, according to the analysis by the Vapor Technology Association, the industry created 3,287 direct vaping-related jobs in North Carolina. These jobs generated more than $120.5 million in wages.[iii] Moreover, the industry has created hundreds of secondary jobs in the Tarheel State, bringing the total economic impact in 2021 to $1 billion. In the same year, North Carolina received more than $45.6 million in state taxes attributable to the vaping industry.

Unfortunately, efforts by anti-vaping organizations and policymakers have negatively affected vape shops in the Tarheel State. The number of employees has decreased by 9.8 percent from 3,645 in 2018 to 3,287 in 2021.[iv] Overall, the economic output from the vaping industry in North Carolina increased by 30.6 percent from $801.2 million in 2018 to $1 billion in 2021.

Youth Tobacco and Vaping Rates

The most recent data on youth tobacco and vapor product use in North Carolina comes from the 2019 Youth Risk Behavior Survey.[v] In 2019, 52.4 percent of North Carolina high school students reported ever trying e-cigarettes, 35.5 percent reported past month use, and 8.3 percent reported using vapor products daily.

It is worthy to note that youth combustible cigarette use is at an all-time low. In 2019, 8.3 percent of North Carolina high school students reported using a cigarette in the past 30 days, a 71.7 percent decrease from 1993 when 29.3 percent of high school students smoked cigarettes. Further, daily cigarette use has decreased by 85.1 percent from 17.7 percent of high school students reporting daily smoking in 1993 to 1.5 percent in 2019.

Moreover, nationally, the youth vaping rate continues to decline. In 2021, according to the National Youth Tobacco Survey (NYTS), an estimated 11.3 percent of high school students and 2.8 percent of middle school students reported having used a vapor product on a least one occasion in the month prior to the survey.[vi] Further, only 3.1 percent of high school students and less than one percent of middle schoolers reported daily e-cigarette use. The rate of decline is remarkable: among high school students, vaping rates have declined by 41.8 percent since 2020 and by 58.9 percent since 2019, when 27.5 percent reported using e-cigarettes.

Young Adult Smoking Rates

Electronic cigarettes and vapor products were first introduced to the U.S. in 2007 “and between 2009 and 2012, retail sales of e-cigarettes expanded to all major markets in the United States.”[vii] Moreover, between September 2014 and May 2020, e-cigarette sales in the U.S. increased by 122.2 percent.[viii]

Examining data from the CDC’s BRFSS finds that e-cigarettes’ market emergence has coincided with a significant reduction in smoking rates among young adults.

In 1998, among current adult smokers, 27.1 percent were 18 to 24 years old. In 2008, this had decreased by 3.7 percent to 26.1 percent of adult smokers in North Carolina being between 18 to 24 years old.

In the years after e-cigarette’s market emergence in the early 2010s, smoking rates among current smokers aged 18 to 24 years decreased by 71.1 percent. Indeed, in 2010, among current smokers in North Carolina, 29.1 percent were between 18 to 24 years old. In 2020, only 8.4 percent of current smokers were 18 to 24 years old.

Interestingly, e-cigarettes’ market emergence was associated with greater declines in average annual percent decreases. Between 1998 and 2008, the percentage of current smokers aged 18 to 24 years old increased on average by 0.9 percent each year. Between 2010 and 2020, annual percentage decreases average at 8.7 percent.

Further, since 2016, when the U.S. surgeon general issued an alarm about youth e-cigarette use, smoking rates among adults aged 18 to 24 years in the Tarheel State have decreased by 50.3 percent, with an average annual decrease of 15.3 percent.

Wasted Tobacco Dollars

Between 2000 and 2020, North Carolina collected an estimated $3.8 billion in cigarette taxes.[ix] During the same 20-year period, the Tarheel State increased the tax rate on cigarettes three times. The last tax increase raised the rate by $0.10, to $0.45 per pack.

The last tax increase did lead to an immediate 11.2 percent increase in cigarette tax revenue the year after the tax was imposed, but this has steadily declined in the long-term. Between 2012 and 2020, cigarette tax revenue declined on average by one percent annually. In 2020, North Carolina collected $235.4 million in cigarette tax revenue, a nine percent decrease from the $258.8 million in cigarette tax revenue that was collected in 2011.

In the mid-1990s, North Carolina sued tobacco companies to reimburse Medicaid for the costs of treating smoking-related health issues. And, in 1998 with 45 other states, the Tarheel State reached “the largest civil litigation settlement in U.S. history” through the Master Settlement Agreement (MSA).[x]

Under the MSA, states receive annual payments – in perpetuity – from the tobacco companies, while relinquishing future claims against the participating companies. Between 2000 and 2020, North Carolina collected $3.1 billion in MSA payments.[xi]

Tobacco taxes and tobacco settlement payments are justified to help offset the costs of smoking, as well as prevent youth initiation. Like most states, North Carolina spends very little of existing tobacco moneys on tobacco control programs – including education and prevention.

Between 2000 and 2020, North Carolina allocated only $164.1 million in state funds towards tobacco control programs.[xii] This is 4.3 percent of what the state collected in cigarette taxes in the same 20-year time span and 5.2 percent of MSA payments. In total, in 20 years, North Carolina allocated only 2.4 percent of what the state received in tobacco taxes and settlement payments towards tobacco education and prevention efforts. In essence, for every $100 received in tobacco-related taxes and settlement payments, the state spent $2.40 funding tobacco control programs.

Summary Points:

• Smoking rates continue to decline in the Tarheel State. In 2020, only 16.5 percent of adults were current smokers. This is a 10.8 percent decrease from 2019.
• Nearly two-thirds (60.4 percent) of all current smokers earned less than $24,999 per year in 2020.
• Nationally, current vapor product use among high school students has declined by 41.8 percent since 2020 and by 58.9 percent since 2019, when 27.5 percent reported using e-cigarettes on at least one occasion in the 30 days prior to the survey.
• E-cigarettes’ market emergence is associated with low young adult smoking rates. In 2020, among current smokers in North Carolina, only 8.4 percent current smokers were 18 to 24 years old – a 71.1 percent decrease from 2010. Further, since 2016, smoking rates among young adults have decreased by 50.3 percent.
• North Carolina’s vaping industry created $1 billion in economic activity in 2021 while generating 3,287 direct vaping-related jobs and contributed more than $45.6 million in state taxes.
• Unfortunately, anti-vaping efforts have reduced the industry’s economic impact. The number of employees decreased by 9.8 percent from 3,645 employees in 2018, and overall economic activity increased by only 30.6 percent from $801.2 million in 2018.
• North Carolina continues to allocate very little of tobacco-related settlement payments and taxes on tobacco control programs, including education and prevention.
• In 2020, the Tarheel State collected $235.4 million in state cigarette excise taxes and $149.2 million in tobacco settlement payments, yet allocated only $2.2 million (0.6 percent) to tobacco control. In 20 years, for every $100 the state received in tobacco-related payments, it spent $2.40 funding tobacco control programs.

[i] Centers for Disease Control and Prevention, “BRFSS Prevalence & Trends Data,” 2020, https://www.cdc.gov/brfss/brfssprevalence/.

[ii] Kids Count Data Center, “Total population by child and adult populations in the United States,” The Annie E. Casey Foundation, September 2021, https://datacenter.kidscount.org/data/tables/99-total-population-by-child-and-adult-populations#detailed/1/any/false/1729,37,871,870,573,869,36,868,867,133/39,40,41/416,417.

[iii] Vapor Technology Association, “The Economic Impact of the Vapor Industry North Carolina,” 2021, https://vta.guerrillaeconomics.net/reports/9b4c6cdd-df6b-4e91-aa7b-067fa05c5556?.

[iv] Vapor Technology Association, “The Economic Impact of the Vapor Industry North Carolina,” 2018, https://vta.guerrillaeconomics.net/reports/0644fe8e-7fd0-459b-9a5b-5a0ccf9985cc?.

[v] Centers for Disease Control and Prevention, “High School YRBS 2019 Results,” 2019, https://nccd.cdc.gov/Youthonline/App/Default.aspx.

[vi] Eunice Park-Lee PhD. et al., “Notes from the Field: E-Cigarette Use Among Middle and High School Students – National Youth Tobacco Survey, United States, 2021,” Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, October 1, 2021, https://www.cdc.gov/mmwr/volumes/70/wr/mm7039a4.htm.

[vii] National Center for Chronic Disease Prevention and Health Promotion, “E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General,” 2016, https://www.ncbi.nlm.nih.gov/books/NBK538679/.

[viii] Fatma Romeh M. Ali, PhD., et al., “E-cigarette Unite Sales, by Product and Flavor Type – United States, 2014 – 2020,” Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, September 18, 2020, https://www.cdc.gov/mmwr/volumes/69/wr/mm6937e2.htm/.

[ix] Orzechowski and Walker, “The Tax Burden on Tobacco Historical Compilation Volume 55,” 2021. Print.

[x] Tobacco Control Legal Consortium, “The Master Settlement Agreement: An Overview,” August 2015, p. 1, http://publichealthlawcenter.org/sites/default/files/resources/tclc-fs-msa-overview-2015.pdf.

[xi] Campaign for Tobacco-Free Kids, “Actual Annual Tobacco Settlement Payments Received by the States, 1998 – 2021,” January 11, 2022, https://www.tobaccofreekids.org/assets/factsheets/0365.pdf.

[xii] Campaign for Tobacco-Free Kids, “Appendix A: History of Spending for State Tobacco Prevention Programs,” 2021, https://www.tobaccofreekids.org/assets/factsheets/0209.pdf.