NC anti-tobacco funding slashed as CDC shuts down Office on Smoking and Health
North Carolina has lost its federal funding for tobacco prevention and control, a cut that state health officials say will limit services, lead to furloughs and stall efforts to reduce smoking and related health risks and deaths across the state.
The cut stems from the Trump administration’s closure earlier this year of the CDC’s Office on Smoking and Health, which had supported state tobacco programs — including North Carolina’s — since 1998.
The office’s $240 million annual budget was a major funding source for state and local governments. In 2024, North Carolina received more than $2.3 million from the office, a part of the federal Centers for Disease Control and Prevention, and combined it with just over $2 million in state funds and additional money from a 2021 settlement with Juul, secured after the state sued the e-cigarette maker.
The N.C. Department of Health and Human Services had expected to receive $2.35 million in May as the fifth and final year of a longstanding federal tobacco prevention grant, said Kelly Kimple, interim director of the Division of Public Health. The grant has been awarded in five-year cycles since 2000.
Instead, the department was issued a six-month “no-cost extension,” allowing the current grant’s period to continue through October without the new additional funding, according to a DHHS spokesperson.
“We’ve been working on trying to maximize what we have remaining. But at the end of the day, with our financial losses, we’re not going to have the capacity to fill (gaps), especially given the overall scope and magnitude of what we’re seeing with regards to public health changes,” Kimple said.
There is “ongoing uncertainty where things will land with the federal government and how we structure our public health system.”
The agency already experienced federal funding terminations in late March, when the Trump administration announced $11.4 billion in immediate cuts to federal grants.
For NCDHHS, these resulted in more than 80 job losses and at least $100 million in funding cuts for the department, as well as dozens of contractors, she said.
Housed within DHHS’s Public Health Division, North Carolina’s Tobacco Prevention and Control Branch works to reduce tobacco use, prevent related diseases, and limit secondhand smoke exposure.
Furloughs start Saturday. Who’s left?
The tobacco funding cut will have several short-term impacts, including the indefinite furlough of nine federally funded public health staff beginning Saturday.
“These are passionate, dedicated individuals with many years of public health experience to lead tobacco cessation and control efforts,” said Kimple.
That leaves three remaining staff members to continue supporting similar efforts. One employee will also remain in each of the 10 Regional Tobacco Prevention and Control Collaboratives, which work across all 100 counties.
These regional public health employees will continue to support local health departments and communities, she said. However, where state-level assistance is needed — such as technical guidance and other services — capacity will be limited.
“It will have to be a narrower scope with the funding that is remaining,” unless alternative sources can be found to support the affected positions, she said.
Beyond the furloughs and the reduction in state-level support, Kimple and DHHS spokesperson Patsy O’Donnell said the state anticipates:
Local programs shifting focus to youth vaping prevention to align with the Juul settlement.
Potential cuts to QuitlineNC services, including reduced nicotine replacement therapy for uninsured and underinsured residents, and elimination of a UNC-led evaluation. QuitlineNC is a free telephone and online service offering resources and support for individuals trying to quit tobacco.
Scaled-back Tobacco-Free NC initiatives.
The funding cut threatens a decade of progress, including a drop in smoking rates among people with mental health and substance use disorders from 40% in 2011 to 13.2% in 2023. The branch led a CDC-supported youth vaping initiative that reached thousands, said DHHS spokesperson Summer Tonizzo. Furthermore, 23 municipalities and four counties, including Wake and Cumberland, enacted zoning rules to limit youth exposure, said DHHS spokesperson Summer Tonizzo.
Asked if there are efforts to request more funding from lawmakers, Kimple said it’s “been something that multiple partners have reached out about and I’m sure that members of our General Assembly probably are also aware.”
In addition to funding states, the CDC office ran national public health campaigns — such as Tips From Former Smokers, which shares real stories from people harmed by tobacco —and conducted the annual National Youth Tobacco Survey, which collects nationwide data on middle and high school students’ tobacco use. The end of OSH also comes amid dramatic changes at the Food and Drug Administration’s Center for Tobacco Products, which regulates tobacco products, according to Stat News.
A spokesperson for the U.S. Department of Health and Human Services told Stat News on the OSH closure that it is “committed to investigating any potential roof [sic] causes of the chronic disease epidemic. Critical programs within the CDC will continue as part of Secretary Kennedy’s vision to streamline operations and create a more efficient HHS.”
“We are continuing to navigate the uncertainty and federal reductions and reorganization. I think we just are doing our best to work to maximize the public health system as a whole for North Carolina and to support North Carolinians,” said Kimple.
Tobacco’s heavy toll
Tobacco remains the leading cause of preventable death in the United States, costing $240 billion annually in health care costs and $372 billion in lost productivity, per OSH data.
In North Carolina, tobacco use claims roughly 14,000 lives yearly, among the one in five U.S. deaths attributed to tobacco, according to a 2024 surgeon general’s report.
Despite a 70% drop in adult cigarette smoking since 1965, disparities persist: youths, Black Americans, LGBTQ+ individuals, low-income communities, and American Indian and Alaska Native populations face higher tobacco use and exposure, says the report.
In 2023, 13.2% of North Carolina adults smoked cigarettes, above the national average of 12.1%. The state’s 2022 youth tobacco survey estimated one in eight high school students used tobacco products, primarily e-cigarettes.
North Carolina’s tobacco history spans almost three centuries, driving tobacco booms across the years. Despite a significant decline since its peak, it remains the top U.S. tobacco producer and exporter.
It remains one of a few states that has not raised the legal age to purchase tobacco from 18 to 21 to align with federal law and that does not require retailers to obtain a license or permit to sell tobacco products. This year, state lawmakers have introduced bills to create a tobacco retail permitting system and raise the legal purchase age to 21. The bills have not passed.
Tobacco prevention programs are considered highly cost-effective. Sustained, evidence-based efforts reduce smoking and related illnesses — and can save states up to $55 in health care costs for every dollar spent, O’Donnell said.
This story was originally published May 16, 2025 at 1:05 PM with the headline "NC anti-tobacco funding slashed as CDC shuts down Office on Smoking and Health."
