BISMARCK, N.D. - The fall election is now less than eight weeks away, and one of the big questions facing North Dakotans is whether to approve a ballot initiative banning smoking in workplaces statewide.

Approval of the measure would lead to better health, according to Janet Maxson, a nurse practitioner in Minot who volunteers with the American Heart Association.

"The mindset of the public is realizing that tobacco-free is the right, as opposed to people not having to breathe secondhand smoke. The evidence-based science now has shown us that all that passive smoke still is a major cause of coronary artery disease and also of death."

While lung cancer is the first disease many think of in relation to smoking, Maxson says, tobacco use is also the leading cause of heart disease.

"Heart disease is still the No. 1 killer in our country and looking all around the world, and tobacco has a huge impact on the risk factors for cardiovascular disease."

Some establishments in North Dakota already are smoke-free voluntarily, and workplace bans already are in effect in a number of cities - so Maxson says statewide is the next logical step.

"I've been kind of polling my patients that have been coming in, and every single one of them that have been in feels that it is time for our state to take this initiative and have it, like so many states have already done - to have a tobacco-free workplace."

Twenty-three states have 100 percent smoke-free workplace laws, including Minnesota, Montana and South Dakota.

The new North Dakota smoke-free workplace law would take effect 30 days after the election if approved. Those against the measure say government shouldn't be able to ban a legal activity inside a private business.

More information is online at facebook.com/SmokeFreeND.


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Nebraska needs to do better when it comes to tobacco use prevention and cessation, according to a newly released report.

In the American Lung Association's 2024 State of Tobacco Control report, Nebraska received an "F" in three of the five areas rated. One is for tobacco prevention and cessation funding.

Michael Seilback, national assistant vice president for state public policy for the American Lung Association, said Nebraska is spending vastly less than what the Centers for Disease Control and Prevention recommends.

"The fact is that the state is taking in these dollars, and we're saying, reinvest just some of them," Seilback explained. "You can easily meet CDC best practices with tens of millions of dollars to spare."

The report showed Nebraska's tobacco-related revenue is nearly $98 million per year. However, for fiscal year 2024, state funding for tobacco control programs is less than $4 million.

On the bright side, the state received an "A" for smoke-free air.

Responding to the report, a spokesperson with the Public Information Office at the Nebraska Department of Health and Human Services pointed to the Nebraska Quitline. It has received more than 100,000 calls since 2000, with Quitline users six to 10 times more likely to still have quit after seven months than those who try to quit cold turkey. The Nebraska Quitline number is 1-800-784-8669, and 1-800-355-3569 for Spanish speakers. Web-based coaching and texting and free "quit medication starter kits" are also available.

The state also received an "F" for tobacco taxes. Seilback called the state's cigarette tax of 64 cents per pack extremely low and supports Gov. Jim Pillen's proposal to increase it by as much as $2 per pack. He added the American Lung Association always pushes for increased tobacco tax dollars to be used for prevention and control and helping people quit.

"To be clear, even if not one dollar was spent -- and we wouldn't encourage it -- on its own, just increasing the price has an impact on the amount of people that use it," Seilback pointed out. "Increasing that price would help prevent kids from starting."

Nebraska's third "F" is on flavored tobacco products, as a result of having no state laws or restrictions.

Seilback commended the state for participating in the multistate lawsuit against e-cigarette manufacturer, JUUL Labs, with the settlement money going to programs to curb addiction.


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Widespread vaping among young Kentuckians continues to be a public health concern - and some local communities are coming up with innovative ways to tackle the issue. A big win in the battle against nicotine came when the Commonwealth raised the age limit to purchase nicotine products to 21.

Lauren Carr, director of the Graves County Agency for Substance Abuse Policy and Prevention, said local shops are still selling vapes to kids. Her county is incentivizing business owners not to sell to minors.

"We reward the clerks that do not sell with a gift card," she said. "So we say, 'Hey, thank you for not selling to the kids. Because that is preventing it from getting into the schools.'"

Experts say tobacco retail licensing can help protect youth from the harmful effects of vaping and can also improve equity among low-income and communities of color, often targeted by the tobacco industry.

According to Kentucky Youth Advocates, about 35 states require retailers to hold a license to sell tobacco products, but Kentucky is not one of them.

Sydney Shafer, a high school student in Scott County, said after her grandfather passed away from lung cancer, she became passionate about raising awareness among state lawmakers about the harms of vaping.

"Big vape companies are targeting younger audiences with fun flavors, like cotton candy and coffee," she argued. "It's deceptive and manipulative, and I would just want to educate other people and let them know that vaping is not as safe as they think."

Bruce Crouch, drug prevention officer with the Youth Coalition Prevention Group at Taylor County High School, said his school district recently received an opioid settlement grant from the state to expand drug prevention work.

"We actually started with our intermediate school, with fourth-graders," Crouch reported. "And we introduced a program, the 'Too Good for Drugs' program. So, they are actually getting that early education about the dangers of nicotine use."

Research from the CDC and FDA finds more than 2.5 million middle and high school students nationwide reported e-cigarette use in 2022. Nearly 85% of youth who vape used flavored e-cigarettes, and more than half used disposable e-cigarettes.


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The Food and Drug Administration will be releasing guidance on its proposed menthol cigarette ban by month's end. In Virginia, these cigarettes make up 45% of the state's menthol cigarette market.

Several states - including California, New York and Rhode Island - have implemented menthol bans in recent years. As beneficial as this move may be for people's health, law enforcement officials aren't as celebratory.

Diane Goldstein, executive director of the Law Enforcement Action Partnership, said the only kind of ban that would work is no ban at all.

"I don't care if it's a tobacco product, a caffeine product, an alcohol product, or the unregulated illicit market that we currently have," she said. "People are always going to find a way to get the drugs that they want."

She noted that enforcing such a ban could be problematic for already disenfranchised communities. The FDA has said its new proposal won't penalize individual smokers - rather, it will penalize distributors. The hope is the ban will improve health across the state and the nation, especially as Virginia ranked poorly in the American Lung Association's 2023 State of Tobacco Control Report.

Goldstein said she feels there should be additional studies done before the proposed rules are finalized to ensure that disenfranchised communities with higher smoking rates won't be so harshly affected. She described the kind of approach she'd want to see taken as part of a ban.

"You have policies that have been in place for years, that include, we need more harm-reduction in the state products for adults," she said. "We need more education, we need better cessation support, we need better youth tobacco prevention."

An analysis of several studies by Quit Now Virginia found that 25% to 64% of adult smokers would quit if menthol cigarettes were banned in the United States.