Background Information
Tobacco use is the leading cause of preventable disease and death in the US and in ND. So should we be concerned? The answer is YES....

  • The life expectancy of smokers is at least 10 years shorter than nonsmokers.
  • Approximately 1000 people die prematurely each year in ND due to illnesses caused by smoking.
  • 18.7% of ND adults smoke, slightly more than the national level of 17.5%.
  • 11.7% of ND high schoolers smoke cigarettes and 21% report current use of electronic vapor products.
  • In ND, the annual health care costs directly caused by smoking is $559 million.

The North Dakota Department of Health (NDDoH) has fact sheets on several different topics.

Data Sources

Campaign for Tobacco Free Kids

ND Substance Use Data Book   2017

ND Youth Risk Behavior Survey

Behavioral Risk Factor Surveillance System

ND Comprehensive Tobacco Prevention and Control State Plan

The current State Plan is coordinated by the North Dakota Department of Health (NDDoH) Tobacco Prevention and Control Program (TPCP). The TPCP implements a process-based and outcomes-based evaluation of programs to keep state government officials, policymakers, and the public informed. Based on the Best Practices for Comprehensive Tobacco Control Programs model outlined by the National Centers for Disease Control and Prevention (CDC) and Community Guide recommendations, the four goal areas under the State Plan are:

  • Prevention Initiation of Tobacco Use Among Youth and Young Adults
  • Eliminate Exposure to Secondhand Smoke (SHS)
  • Promote Quitting Tobacco Use
  • Build Capacity and Infrastructure to Implement a Comprehensive Evidence-Based Tobacco Prevention and Control Program.

Tobacco Prevention and Control Grant
The Tobacco Prevention program works to promote and advocate for comprehensive tobacco free policies in the community. The goals, objectives, and strategies of the program are in line with those of the State Plan. The strategies help create and change the social norm of tobacco use to make it less desirable, less acceptable and less accessible.Some of the activities NGDHU has taken towards each goal and create healthier, tobacco free communities are listed below:

Prevent Youth Initiation

Educate and meet with local leaders, partners, and stakeholders to coordinate and expand advocacy efforts around raising the price of tobacco products.

Research indicates that each 10% cigarette price increase reduces youth smoking by 6.5%, adult smoking rates by 2%, and total consumption by about 4%. The benefits create new revenues and decrease health care spending. With the average cigarette tax at $1.75 per pack, ND is currently at $0.44 per pack and ranks 47th in the nation.

Provide assistance to area schools in creating and implementing comprehensive tobacco-free policies.

Comprehensive tobacco free school policies were adopted by Lakota School District, Dakota Prairie School District, Griggs Co. Central School District and Midkota School District in 2011 and 2012. The Model School Policy was sent to all 4 school districts for their review. Policies for Lakota School District, Dakota Prairie School District and Griggs Co. School District were reviewed and revised by our office to include e-cigarettes, JUULs and other emerging nicotine delivery systems.

Provide tobacco prevention advocacy training to local youth.

Students in the Raider Vision classes created 4 short videos about tobacco use.

A statewide Youth Summit will be held in October 2018 in Bismarck. (More information coming soon.)

Promote Cessation

In 2015, 55.8% of ND’s adult smokers tried to quit. (National Health Interview Survey, 2015) 47.4% of ND high school smokers tried to quit in 2015. (YRBS 2015). NDQuits provides free, confidential cessation assistance to any North Dakota resident interested in quitting tobacco. This also includes helping quit the use of smokeless tobacco.

Check with your individual health insurance plan to see what services and products might be covered. ND Medicaid provides coverage of some products with pre-authorization from your physician.

Our office has Quit Kits available to help you on your journey to be tobacco free. Stop by and get one.

Other products such as smokeless tobacco, e-cigarettes or JUULs are not without risks. The tobacco industry markets these products as a safer alternative to smoking. The industry promotes using smokeless tobacco where smoking is prohibited. Unfortunately we are seeing more dual usage of products and cigarettes.

Reduce and Eliminate Exposure to Secondhand Smoke

Maintain comprehensive smoke-free laws in ND.

In November 2012, North Dakota passed one of the strongest laws in the US to protect all citizens from secondhand smoke and prevent youth initiation of tobacco products.
Through ND's current smokefree law, most workplaces and public places are smokefree.

There is no safe exposure to secondhand smoke to adults or children. This has been well documented by the U.S. Surgeon General Report on the Health Consequences of Involuntary Exposure to Tobacco Smoke (2006).

Increase the number of policies addressing smoke-free multi-unit housing and work places not protected under the current law.

Increase the number of smoke-free policies in outdoor areas not protected under the current law.

Build Capacity and Infrastructure

NGDHU utilizes social media, quarterly newsletters, local newspapers and other avenues to promote tobacco-free messaging. The use of media to counter the tobacco industry's advertising and promotional activities to manipulate and influence youth is an important strategy.


July 2018

March 2018

December 2017

September 2017

June 2017

Staff actively participate in the state Youth and Policy workgroups to network with colleagues and implement new ideas and strategies.

Related Links
BreatheND website



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