As one of the tobacco-growing states, North Carolina has a long history with tobacco farmers and manufacturers. However, because smoking is the leading cause of preventable death and disease in the US, the state has launched several tobacco cessation and prevention initiatives to curb tobacco smoking among North Carolinians.
Part of North Carolina’s stop-smoking efforts is Senate Bill 116 or the 2023 Youth END (End Nicotine Dependency) Act. Although similar bills from previous years were shelved by the Republican-controlled state legislature, a bipartisan group of state sponsors is pushing through with this attempt to have a $17-million annual fund for tobacco use prevention. Below, we take a closer look at how this fund will be spent, as well as other equally important programs to end smoking in North Carolina.
Proposed tobacco prevention fund
The primary sponsors of SB116 are proposing $17 million to be placed annually in the Tobacco Use Prevention Fund. This funding will come from the Master Settlement Agreement (MSA), to which tobacco manufacturers like R.J. Reynolds Tobacco Co. and Philip Morris USA agreed to settle lawsuits over smoking-related healthcare costs in states including North Carolina. Smoking costs the average North Carolina smoker about $1.76 million in healthcare and income loss over a lifetime, making it reasonable for the state’s $134.1-million share in MSA perpetual payments to be invested in smoking cessation and prevention programs.
In this light, the annual state funding would have a multi-pronged strategy. To raise awareness about the health risks of tobacco, there will be prevention initiatives among the military and evidence-based media campaigns for the general public. Meanwhile, grants for promoting tobacco-free community college campuses and educational efforts between health departments and school districts will address the use of new and emerging tobacco products among the youth. The funding will also be spent on tracking tobacco use among at-risk populations and evaluating the impact of the aforementioned programs.
Other stop-smoking efforts in North Carolina
Considering quitting smoking can be challenging due to intense cravings and withdrawal symptoms, other public health efforts in North Carolina focus on easing smokers’ transition to cessation. For instance, WWXII 12 reports that local convenience stores are now ordered by the court to display new warning signs when selling cigarettes and similar combustible tobacco products. This effort aims to further reduce smoking rates and point smokers toward cessation aids, such as nicotine replacement therapy (NRT), to help avoid relapse.
While North Carolina-based Reynolds American Inc. removed their Zonnic nicotine gum from US stores in 2019, residents have plenty of other options. One of the most popular NRTs is the nicotine pouch, which is available online. Although relatively new as an oral NRT product, the best-selling ZYN wintergreen nicotine pouches are discreet, tobacco-free, and can deliver a satisfying nicotine experience through their icy burst of flavor. Smokers who are looking for a reduced-risk nicotine product can order these online through the retailer Prilla, which ships via UPS to all states, including North Carolina, within 2-7 business days. By using these NRTs, smokers can reduce the intensity and frequency of cravings, helping them achieve successful and long-term cessation.
Additionally, the state has launched a behavioral change program that can complement the use of NRTs for improved cessation. Through the highly effective QuitlineNC services, not only do smokers get access to free NRT such as patches with gums and lozenges, but they also receive special counseling from certified quit coaches through live chat or text. There are also tailored programs for particularly vulnerable populations like the youth, pregnant women, and individuals with behavioral health conditions.
Overall, smoking remains a public health issue that lawmakers, health professionals, and public institutions in North Carolina must address on all fronts through effective policy and government funding for the wide availability of cessation aids and behavioral support.

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