North Carolina's Tobacco Tightrope: Balancing Federal Funding and Youth Access

North Carolina finds itself in a precarious position as it navigates the complex landscape of federal funding for substance use disorder treatment and prevention. The state's high retailer violation rate for tobacco sales to minors threatens to jeopardize millions in critical funding, forcing lawmakers to confront the challenges of enforcing youth tobacco access laws.

Safeguarding Substance Use Treatment Funding Amid Tobacco Compliance Concerns

Teetering on the Funding Precipice

North Carolina is on the verge of losing approximately .4 million in federal funds earmarked for combating the opioid epidemic and supporting substance use disorder treatment. This potential loss of funding hinges on the state's ability to address its high retailer violation rate for tobacco sales to individuals under the age of 21, the federal minimum tobacco sale age.

Navigating the Compliance Conundrum

Federal law requires states to annually survey a random sample of tobacco retailers and report the percentage of them that sell to people under 21. If this retailer violation rate exceeds 20% (with a +/-3% margin of error), the state could face penalties, including up to a 10% reduction in its grant funding. North Carolina's retailer violation rate has been pushing the margin of error, reaching 21.9% in the 2023 federal fiscal year.

Enforcement Challenges and Regulatory Gaps

The state's high retailer violation rate can be attributed, in part, to limitations in state law enforcement authority. North Carolina's Alcohol Law Enforcement agency is only empowered to enforce the state's minimum tobacco sale age of 18, rather than the federal minimum of 21. This hinders the agency's ability to effectively reduce tobacco access for 18- to 20-year-olds.

Addressing the Tobacco Licensing Void

North Carolina's lack of a comprehensive tobacco retailer licensing system further exacerbates the enforcement challenges. As one of only 16 states without such a system, the state lacks an official list of tobacco retailers, making it difficult for law enforcement to track new stores and ensure compliance with youth tobacco access laws.

Navigating the Transition Period and Corrective Action

While states out of compliance with the 20% retailer violation rate law have not faced penalties in recent years due to a transition period mandated by Congress, that period is set to end this December. North Carolina must now explore options to avoid the loss of substance use treatment funding, such as negotiating a corrective action plan with the federal Department of Health and Human Services or committing more state resources to compliance efforts.

Legislative Efforts and the Vaping Conundrum

Lawmakers in North Carolina have taken steps to address the issue, such as the recent passage of HB 900, which will create a registry of vape products authorized by the Food and Drug Administration. However, the state's minimum tobacco age remains a point of contention, with some legislators advocating for alignment with the federal minimum age of 21, while others argue for maintaining the state's current age of 18.

Tobacco Prevention and Education: A Persistent Challenge

Despite the challenges, North Carolina has a long history of tobacco prevention and education efforts, partnering with various state, regional, and local organizations to implement evidence-based strategies. However, the elimination of state funding for tobacco control in 2013 and the subsequent delay in new funding have hindered the state's ability to effectively address the issue.

Charting a Path Forward: Balancing Compliance and Funding

As North Carolina navigates this delicate balance between federal funding requirements and youth tobacco access, the state must remain diligent in its efforts to reduce youth tobacco use and access. Addressing the regulatory gaps, strengthening enforcement capabilities, and securing sustainable funding for tobacco prevention and education will be crucial in ensuring the state's compliance and safeguarding the critical resources needed to combat the opioid epidemic and support substance use disorder treatment.