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About DHEC

Issue: Tobacco Use in South Carolina

The South Carolina Department of Health and Environmental Control’s Division of Tobacco Prevention and Control provides state-based, comprehensive tobacco prevention and control services.

Tobacco use remains the single most preventable cause of death and disease in the United States and the state. It is one of the most significant modifiable risk factors for the three leading causes of death in S.C., heart disease, cancer and stroke. It causes significant lung disease, emphysema and damages nearly every organ in the human body.

  • The vast majority of tobacco users began in early adolescence; most first use occurs before age 18.
  • An estimated 45 million American adults currently smoke cigarettes.
  • Annually, cigarette smoking causes approximately 443,000 deaths.
  • For every person who dies from tobacco use, another 20 suffer with at least one serious tobacco-related illness.
  • Half of all long-term smokers die prematurely from smoking-related causes. In South Carolina, the picture is similar.

Burden of Tobacco Use in South Carolina

Adults - According to DHEC’s 2009 S.C. Behavioral Risk Factor Surveillance Survey and the Campaign for Tobacco Free Kids (TFK), 20.4 percent, or about 710,000 adults in the state currently smoke cigarettes. Overall, 6,100 adults in the state die each year from their own smoking.

Youth - Among high school students, 21.8 percent or 48,011 were current cigarette smokers in 2009. An additional 6,300 become new daily smokers each year, and 240,000 are exposed to secondhand smoke in their home. A projected 103,000 young people who are alive today will eventually die prematurely from smoking, all according to TFK.

Costs - In addition, TFK reveals that $1.09 billion dollars in health care costs are directly caused by smoking, costing each resident, whether they smoke or not, $562 in state and federal tax burden each year.

While these numbers are staggering—smoking kills more people than alcohol, AIDS, car crashes, illegal drugs, homicides, and suicides combined—there are proven strategies that can reduce the toll tobacco use takes on society.

Trends and Influences

Over the past six years, adult smoking prevalence has dropped 25 percent, from 26.6 percent in 2002 to 20.4 percent in 2009. Likewise, South Carolina has experienced a drop in youth prevalence as well, declining 48 percent from its highest level of 36.6 percent in 1999 to a 2007 rate of 18.7 percent. Unfortunately, there was a slight increase in 2009 to 21. 8.

Continued full and systematic implementation of Best Practices in Tobacco Control will result in continued improvements in these important indicators.

Strategic Approaches

The mission of a Comprehensive Tobacco Control Program is to reduce disease, disability and death related to tobacco use. This comprehensive approach optimizes synergy from applying a mix of educational, clinical, regulatory, economic and social strategies and is established as the guiding principles for eliminating the health and economic burden of tobacco use. The goal areas include:

  • Preventing Initiation Among Youth and Young Adults
  • Promoting Quitting Among Adults and Youth
  • Eliminating Exposure to Secondhand Smoke
  • Identifying and Eliminating Tobacco-Related Disparities

The Division of Tobacco Prevention and Control has developed strategies and objectives to meet these four goal areas which correspond directly to the guidance in the documents “Key Outcome Indicators for Evaluating Comprehensive Tobacco Control Programs”, the SC State Plan “Addressing the Toll of Tobacco Use in SC” and National Health Promotion and Disease Prevention Objectives.

In the area of Prevention, population based policy and environmental change strategies that model tobacco-free behaviors as the norm and seek to de-normalize and deglamorize tobacco use are most effective in deterring young people from starting. Under this goal area, objectives to prevent youth initiation of tobacco use focus on reducing initiation and prevalence by young people; reducing susceptibility to experimentation with tobacco products; increasing the unit price on tobacco products; increasing knowledge of, improved attitudes towards, and support for policies to reduce youth initiation; and increasing initiation policies and programs in schools.

Helping tobacco users quit deserves full and immediate attention if South Carolina is to produce significant reductions in tobacco use across the state. By enabling tobacco users to make more attempts at quitting and by ensuring that health systems throughout the state adopt a standard way to address tobacco use and dependence, we will be promoting sound tobacco cessation policy change that can result in measurable improvements in the prevalence of chronic illnesses that are directly linked to tobacco use, particularly smoking.

Eliminating exposure to secondhand smoke has a considerable impact on the health and well being of a community. Local participation in processes to bring about protections in public places and work places is a key element to the moderate success now being experienced across South Carolina. In order to bring about the elimination of nonsmokers exposure to secondhand smoke, program efforts focus on reducing exposure to secondhand smoke; reducing tobacco consumption; assuring compliance with tobacco-free policy; increased knowledge, improved attitudes, increased support for the creation of tobacco-free policies; and the actual creation of these policies.

Certain population groups in South Carolina suffer at disproportionate rates from the death and disease brought on by tobacco use. Efforts to identify and eliminate these disparities are integrated into the activities of the three previous goal areas, as they are interconnected. Disparate groups as identified by the Division of Tobacco Prevention and Control include pregnant women, those with low socioeconomic status, the uninsured and youth.

Future Direction
The Division of Tobacco Prevention and Control will continue to collaborate with partners to implement the evidence-based approaches to reduce the preventable deaths and disability from tobacco. The division will continue to build on the successes and seek ongoing and consistent funding, which is critical to sustaining the implementation of effective strategies.

For more information about the Division of Tobacco Prevention and Control, please visit