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NORTH CAROLINA

Analysis and insight on tobacco and vapor

products in the Tar Heel State

TOBACCO HARM REDUCTION 101: NORTH CAROLINA

Key Points:

  • In 2023, 1.1 million North Carolina adults (13.2 percent) were currently smoking. This is a 9 percent decrease from 2022 and represents 91,374 fewer adults smoking.

  • Among all smoking adults in North Carolina in 2023, 14.5 percent were 18 to 24 years old, 62.3 percent were 25 to 44 years old, 19.3 percent were 45 to 64 years old, and 3.9 percent were 65 years or older.

  • Among all adults earning $25,000 or less in 2023, 23.3 percent were currently smoking compared to 8.2 percent of adults earning $50,000 or more.

  • Among all smoking adults in North Carolina in 2023, 62.9 percent were White, 24.6 percent were Black, 10.7 percent were Hispanic, 1.4 percent were American Indian/Alaska Native, and 0.5 percent were Asian.

  • In 2023, 713,905 North Carolina adults (8.4 percent) were currently using e-cigarettes. This is a 6.4 percent increase from 2022 and represents 52,907 additional adults vaping.

  • Among all vaping adults in North Carolina in 2023, 31.3 percent were 18 to 24 years old, 50.4 percent were 25 to 44 years old, 14.2 percent were 45 to 64 years old and 4.1 percent were 65 years or older.

  • In 2023, for every one North Carolina high school student who was smoking, more than 58 adults were currently using cigarettes.

  • In 2023, for every one North Carolina high school student who was vaping, more than six adults were currently using e-cigarettes.

  • The introduction of e-cigarettes has not led to increases in cigarette smoking, but rather, correlates with significant declines in smoking rates among young adults.

  • Between 2007 and 2023, smoking rates among North Carolina adults aged 18 to 24 years old decreased by 83.1 percent.

  • E-cigarette use has decreased among North Carolina young adults. Between 2022 and 2023, e-cigarette use among 18- to 24-year-olds decreased by 4.2 percent.

  • Cigarette excise taxes in North Carolina disproportionately impact low income and low education persons, while failing to significantly reduce smoking rates among that class.

  • Among North Carolina adults earning $25,000 or less, smoking rates decreased on average by 1.2 percent annually between 2003 and 2023, while rates among adults earning $50,000 or more decreased by 3.3 percent during the same period.

  • In 2023, low-income adults were 2.8 times more likely to smoke than high income earners.

  • In 2023, among North Carolina adults who did not graduate high school, 25.6 percent were currently smoking, while only 4.6 percent of college graduates were smoking.

  • In 2023, adults lacking a high school diploma were 5.6 times more likely to smoke than college graduates.

  • North Carolina woefully underfunds programs to prevent youth use of tobacco and/or vapor products and help adults quit smoking, while simultaneously receiving millions of dollars from the pockets of the adults who smoke. In 2023, for every $1 the state received in tobacco monies, it spent only $0.04 on tobacco control efforts.

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©2025 by Tobacco Harm Reduction 101. 

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