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Research

Carolina receives contract to study e-cigarette use

UNC School of Medicine researchers will use funding from the N.C. Department of Health and Human Services to explore ways to reverse e-cigarette trends in youth and young adults.

A two-picture collage with a pair of headshots: On the left is Dr. Leah Ranney. On the right is Dr. Adam Goldstein.
Dr. Leah Ranney and Dr. Adam Goldstein (UNC School of Medicine)

The Tobacco Prevention and Evaluation program in the UNC School of Medicine has been awarded a two-year, $887,431 contract from Juul Settlement funds received by the N.C. Department of Health and Human Services to better understand electronic cigarette use among our youth and young adults. 

In North Carolina, e-cigarettes continue to be the most popular tobacco product among young people. Since e-cigarettes were first made available in 2011, rates of youth e-cigarette use in North Carolina have increased, impacting 20.9% of high school students and 6.1% of middle school students in 2019. Nationwide, lung damage related to use of e-cigarettes has risen sharply since 2020, with many suffering from continued respiratory issues. 

In 2019, North Carolina filed a lawsuit against JUUL Labs, Inc., for their purported role in the state’s vaping epidemic among youth and young adults, becoming the first state to do so. JUUL is the largest e-cigarette manufacturer in the U.S. and, at the time, was the most popular e-cigarette brand in the state. 

The maker of e-cigarettes consented to settle with North Carolina in 2021. As part of the consent order, JUUL was required to alter its business practices significantly and pay $40 million to NCDHHSto support initiatives that aid smokers in quitting, fight e-cigarette addiction and advance scientific research. 

“In recent years, we have noted a stark increase in electronic cigarette use among middle and high school students,” said Dr. Leah Ranney, research associate professor in the family medicine department and director of TPEP. “This contract will support activities to help reduce this alarming trend among North Carolinians.” 

A portion of the settlement funding was awarded to TPEP. The contract will help researchers, school personnel, parents and public health practitioners better understand youth and young-adult vaping (e-cigarette) and emerging tobacco product trends in North Carolina. The contract was awarded by the NCDHHS Tobacco Prevention and Control Branch, and the effort will be led by Ranney at Carolina. 

For more than 20 years, TPEP has worked collaboratively with the TPCB to conduct program evaluation on N.C. tobacco control programs like the QuitlineNC and to analyze responses from the school-based N.C. Youth Tobacco Survey, one of only two sources for N.C. youth risk behavior data. TPEP will use a variety of qualitative and quantitative data-collection strategies to evaluate trends in youth and young-adult vaping (e-cigarette) and emerging tobacco products. 

“This contract will provide critically important data on the current perceptions of tobacco products, including e-cigarettes, within our state,” said Dr. Adam Goldstein, director of the UNC-Chapel Hill Tobacco Intervention Programs. “Learning more about current e-cigarette perceptions among multiple stakeholders, including teachers, could point us to better ways to intervene early and ultimately improve the life-long heath of North Carolinians.” 

The new project is one of the many funded through the JUUL settlement funds that seek to promote cessation, prevent e-cigarette addiction and research e-cigarettes across North Carolina. 

“While we still do not know all the short- and long-term health effects of vaping, everyone agrees that youth should not use any tobacco product, including vapes,” said Goldstein, who is also the Elizabeth and Oscar Goodwin Distinguished Professor in the family medicine department.