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Americans, and 10.8%are Hispanic/Latinx. Current Orange County middle school students' use of tradition- smokers by age, within Region 5, are shown below, with al cigarettes follows the statewide NC declining trend; the highest percentage of smokers occurring among however, the increasing trend of e-cigarette use by mid- those aged 45-54. Individuals with a college degree or dle schoolers both statewide and in Orange County is higher and a household income of more than $75,000 alarming. The use of traditional cigarettes fell from 15% per year were less likely to smoke34. in 1999, to 10% in 2013, to 2.5% in 2017 among NC mid- dle school students. Meanwhile, in 2011, approximately The emergence of new tobacco products such as 1%of NC middle school students used e-cigarettes, electronic cigarettes and the dramatic rise in their use, and in 2017 this percentage increased to approximate- especially by adolescents and young adults, are a signif- icant public health concern. The 2017 percentage of NC vaping associated lung injury (Vaping/EVALI) has been students using e-cigarettes or vaping is 17%, compared reported in 73 individuals in NC and in one individual in to 16.8% in 2015, and 1.7% in 2011. Electronic cigarettes Orange County. have become the most popular tobacco product for youth and adolescents in the U.S. and are attracting OCHD has taken a three pronged approach to help curb youth to new avenues for nicotine addiction. While the local use and addiction of tobacco and nicotine. electronic cigarettes have been known to help some This approach includes: 1) educating Orange County smokers quit, the long-term health effects of these youth, among both school systems, on electronic ciga- products, and the net public health effect associated rette use and its dangers, 2) offering tobacco cessation with their use, remain unclear. through Nicotine Replacement Therapy (NRT) patches, gum or lozenges to those who live or work in Orange Among students in Orange County. County, and 3) continued implementation and educa- • 29% of high school students in Orange County tion around the Smoke-Free Public Places Rule, that Schools (OCS) reported having not smoked tradi- was adopted in October of 2012 by the Orange County tional cigarettes within the past 30 days. Board of Health to ban smoking in public places includ- ing bars and restaurants. • 1 in 5 OCS students reported using an electronic vapor product or vaping within the past 30 days. Below is anon-inclusive list of local and state programs and initiatives to help address and combat tobacco use • Approximately 56%of OCS high school students did and prevention. not think electronic-cigarettes or vaping products posed a risk to their health. Freedom House Recovery Center • In 2017,13% of high school students in Chapel Hill NC QuitLine Carrboro City Schools (CHCCS) reported using an NC Tobacco Prevention and Control Branch e-cigarette within the past 30 days. • In 2017, 29%of CHCCS high school students reported Orange County Health Department ever having used an e-cigarette. UNC Horizons Program UNC Nicotine Tobacco Treatment Center You Quit Two Quit Figure 7: Current Smokers by Age - Region 5 0 5• ° 20.90% 21.20% 20.00% 18.40% o 14.60 15.00% 10.00% ° 5.00% 0.00% 18-34 years of 35-44 years of 45-54 years of 55-64 years of 65-74 years of 75+years of age age age age age age 2019 COMMUNITY HEALTH ASSESSMENT 15