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Could the “Parents’ Rights” legislation hinder the battle against youth tobacco use in Cumberland County?


Ask Commissioner Glenn Adams, and he’ll tell you he sees people vaping from his downtown Fayetteville office every day. 

“I sit and look out my window,” he told CityView on Monday. “You see the people vape, and you see a big plume of smoke that comes out.” 

Those visuals, on top of the feedback he’s received from worried Cumberland County teachers and residents, have concerned Adams, the chairman of the county’s board of commissioners. 

“The [tobacco] industry itself, to me, is trying to entice people to vape,” he said. “These teachers, they’re telling me, even in the bathrooms, the kids are vaping. They’re vaping with these pens. It’s becoming a problem.” 

Since 1999, concerned policymakers like Adams, school personnel and healthcare workers have been able to track the issue using data from North Carolina’s Youth Tobacco Survey, which has been administered every two years to students in grades 6-12, according to the N.C. Dept. of Health and Human Services. But with the new parents’ rights legislation passed by the General Assembly last year, mixed messages have emerged around this year’s survey. The News & Observer reported last month that one NCDHHS official said the survey would be paused, which was quickly followed by an email from a spokesperson stating the survey would simply be delayed in 2023. 

Lawmakers will likely address the issue when the General Assembly’s short session starts in April — but until then, what do county officials know about tobacco use in Cumberland County’s youth, and what can they do? 

What the law says

When Senate Bill 49 — otherwise known as the “Parents’ Bill of Rights” — became law in August, student surveys became one of a slew of issues school administrators suddenly had to contend with. According to the text of the bill, parents now have the right to opt in to data collection of their children, with students only allowed to participate in “protected student information surveys” with parental permission. 

The law defines protected student information surveys as any survey, analysis or evaluation that would reveal information about: 

  • The student or their parent’s political affiliations or beliefs.
  • The student or their parent’s mental or psychological problems.
  • “Sex behavior or attitudes”.
  • “Illegal, antisocial, self-incriminating or demeaning behavior”.
  • “Critical appraisals” of anyone the respondent might have a close family relationship with.
  • Relationships that are legally recognized as privileged or seen as privileged, like relationships with lawyers, doctors and priests.
  • The student or their parent’s religious practices, affiliations or beliefs.
  • Income, other than information required by the law to determine if a student is eligible to participate in a program or receive financial assistance under a program.

Schools must reach out to parents for permission at least 10 days before the planned administration of such surveys, according to the bill. School administrators also must make the full text of the survey available to parents electronically and in person within that time frame, the bill states.

‘That data is very important to us’

Cumberland County Health Director Dr. Jennifer Green said Tuesday that the state’s Youth Tobacco Survey provides crucial data to counties. 

“That data is very important to us,” she said. “We’re gonna have to work with the state to figure out how to get some key metrics around tobacco use in the absence of that survey, because that survey is very helpful … We don’t have the good local data that we’d like to have.”

Green said the county gets some data from the Robert Wood Johnson Foundation’s county health rankings, which come out every spring, but even those analyses are largely focused on tobacco use in adults, not youth. 

“There really is a gap in some of the local data that we would like to have,” she said. 

According to the results of the 2022 North Carolina Youth Tobacco Survey, of the 3,892 students who responded, an estimated 57,300 high school students and 18,600 middle school students in North Carolina use tobacco. E-cigarettes, commonly called “vapes,” are the most popular tobacco product consumed by youth, the survey found.

Flavored e-cigarettes comprised 90.8% of high school users’ and 95.6% of middle school users’ tobacco product of choice, according to the survey results.

Though a 2023 survey by the Centers for Disease Control found tobacco use had declined among high school students from 16.5% in 2022 to 12.6% in 2023, tobacco use has increased in middle school students. The CDC’s survey reported 6.6% of middle school students use tobacco, a 2.1% increase from 2022. 

Green said the issue of youth vaping isn’t new, but it does remain a challenge for county officials. 

“It’s been a priority for our board of health and our commissioners,” she said. “It’s not just one solution … We need that policy change to happen, and then we need to couple that policy change [with] education, referrals to [QuitlineNC], access to treatment — all of those things that are really needed to have a comprehensive approach.” 

QuitlineNC is a program through NCDHHS that provides free tobacco cessation services to any North Carolina resident in need, according to the program’s website. Its Live Vape Free program offers help to North Carolina teens ages 13-17, who can enroll by texting VAPEFREENC to 873373.

What Cumberland County is doing

The Cumberland County Board of Commissioners approved new restrictions on vape and hemp shops last month in an initiative led by Adams, who said he was inspired by an October ordinance passed by the Wake County Board of Commissioners. Now, in unincorporated locations in the county, new retail establishments primarily selling nicotine and hemp products cannot open within 1,000 feet of an existing or permitted shop or any schools, daycare facilities, public parks, group homes, residential rehabilitation support facilities or halfway houses, according to the amendment’s text.

The city of Spring Lake had previously made a similar change in 2019, Adams said, and the city of Fayetteville is looking to adopt a similar ordinance. The county’s board of health is also working on a policy that will ban vaping on county property, he said. 

“Sometimes, I think kids don’t understand how bad this vaping is, because you see [it on] TikTok [and it] becomes a fad,” Adams said. “Young folk are more impressionable, but it’s a health concern throughout the whole county … We’ve got some of the worst health outcomes in the state.” 

Cumberland County Schools could not respond in time for this article’s publication to questions from CityView about nicotine use in schools.

Green said officials are working to reshape the messaging they put out around nicotine use, especially with vaping. 

“We have a lot of students that are vaping or have at least tried it and are using it in different formats that might look like a highlighter [or] a USB drive,” she said. “Students are consuming those tobacco products in a different way, and that means we have to change our approach to it.” 

According to Green, her department is currently involved with the following initiatives to address tobacco use in youth: 

  • CATCH My Breath, a statewide program that focuses on vaping and nicotine prevention. Green said her department does not have the staffing to place employees in every school, but is working to train teachers who can employ the program in their schools.
  • Increased referrals to Quitline NC. 
  • Working with behavioral health facilities to ban tobacco and vaping on their campuses. 
  • Working with a regional tobacco coordinator to shape local policies around tobacco use and vaping.
  • Working with Fort Liberty to assess its culture around tobacco use and educate soldiers on the dangers of nicotine.
  • Hosting Tobacco Treatment Specialist training for community partners to allow them to educate patients on how to quit tobacco.

While schools await the final word on if the statewide tobacco survey can resume, researchers are working on ways to gauge youth tobacco use. The UNC School of Medicine won a two-year contract in July with NCDHHS to research e-cigarette use in youth and young adults. The $887,431 project is funded with part of the $40 million that Attorney General Josh Stein won in 2021 in a legal battle with JUUL Labs, Inc., the creator of the popular JUUL e-cigarette.

And in the meantime, local officials’ battle against nicotine use will continue, Adams and Green said. 

“I think it’s bigger than just our kids,” Adams said.

Reporter Lexi Solomon can be reached at lsolomon@cityviewnc.com or 910-423-6500. 

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Cumberland County, nicotine, schools, legislation, young people, health