Tobacco Use Prevention & Control

The Tennessee Tobacco QuitLine is a toll-free telephone service that provides personalized support for Tennesseans who want to quit smoking or chewing tobacco.

When you call the QuitLine you will be assigned your own quit coach. Your quit coach will help you understand how to quit tobacco and help you develop a plan that works for you. The plan will fit YOUR needs and you have the same quit coach for a whole year.

The quit coach’s help you figure out what works best for you. A quit coach doesn’t tell you what to do. You work with a quit coach to make changes that fit your life.

No. Services provided through the QuitLine are free of charge to all residents of Tennessee.

Intake personnel explain the services offered by the Tennessee Tobacco QuitLine. They gather basic personal information, tobacco history and assign you to a professionally trained quit coach.

Eastern Time

• Monday through Friday: 8:00 a.m. – 11:00 p.m.
• Saturday: 9:00 a.m. – 6:00 p.m.
• Sunday: 11:00 a.m. – 5:00 p.m.

Central Time

• Monday through Friday: 7:00 a.m. – 10:00 p.m.
• Saturday: 8:00 a.m. – 5:00 p.m.
• Sunday: 10:00 a.m. – 4:00 p.m.

All calls are completely confidential. Some calls are recorded for training and quality assurance.

There is no limit to the number of times a person may call the QuitLine.

Even if you’ve used tobacco for decades, the benefits of quitting are considerable and immediate. Within 20 minutes of giving up tobacco, elevated blood pressure and pulse decrease. In two days, nerve endings regenerate. In two weeks, circulation improves. In one to nine months, fatigue and shortness of breath decrease. In one year, the risk of a heart attack is cut in half.

Nicotine Free Schools K-12 Policy Toolkit for Educators and Administrators

The Tobacco Use Prevention and Control Program created this toolkit to support schools, parents, and communities in protecting youth from tobacco and nicotine. Inside, you’ll find:

• Practical tips for enforcing a tobacco-free policy at your school
• Tools to help educate students about the dangers of tobacco and nicotine use
• Resources designed for parents and guardians
• Guidance on how to help youth quit tobacco and nicotine products

Download the toolkit to access evidence-based strategies and resources that promote a healthier, tobacco-free environment for all students.

Model Policy and Enforcement

As an administrator or educator, you can support a tobacco-free environment by adopting this model policy. For assistance with implementation, contact your local health department.

Policy Overview

• The use of tobacco products—including smokeless tobacco, e-cigarettes, vapor devices, and related paraphernalia—is prohibited for all persons (students, staff, contractors, and visitors) on school grounds at all times.
• Tobacco use is also banned in public seating areas (such as bleachers and restrooms), in all district-owned vehicles, and during any school-sponsored activity where students or staff represent the district.

Enforcement

• Principals will apply progressive discipline for students, starting with less punitive actions and including referrals to cessation resources such as the Tennessee Tobacco QuitLine.
• Employees are subject to established personnel policies.
• Visitors must refrain from use or leave the premises; refusal may result in law enforcement action or forfeiture of admission fees.

Support and Resources

• The district will work with county health departments and health organizations to provide education and referrals for students and staff seeking help to quit.

Notification

• Signs will be posted across all district facilities stating: “This is a tobacco-free campus. The use of tobacco products, including battery-operated devices, is prohibited on school property at all times.”
• This policy applies whether or not school is in session.

Note
This model policy was developed by the Tennessee Department of Health, Division of Family Health and Wellness, as guidance for school boards. Consult with legal counsel before adoption or modification.

Additional Model Policies

• Tennessee Department of Health Model Policy

Tobacco-Free Policy Tools for Schools

• No Smoking, Vaping, or Chewing Tobacco Sign - Download and display this sign to remind students, staff, and visitors that tobacco use is not allowed.
• Tobacco-Free School Sign - A larger sign designed for entrances and outdoor areas to clearly mark school property as tobacco-free.
• Tobacco-Free Poster - A visual reminder for hallways and classrooms to promote healthy, tobacco-free environments.
• Healthy Kids Poster - Encourages students to make healthy choices and avoid tobacco and nicotine products.
• Vaping Prevention Resource - Educational materials to help schools teach students about the risks of vaping.
• Flavored Tobacco Toolkit - Lessons and strategies for addressing flavored tobacco use and supporting policy implementation.

Alternatives to Suspension

Instead of suspension, schools can use supportive approaches that educate students, provide resources, and encourage healthier choices. The following tools can help administrators and educators constructively address nicotine use:

INDEPTH: An Alternative to Suspension or Citation - A program from the American Lung Association designed to help students understand the risks of nicotine use and support positive behavior change.

Vaping Prevention and Education: Resources for Talking with Students - Classroom and counseling tools to guide conversations with youth about vaping and nicotine.

Tennessee Tobacco Quitline Business Card (English)

Tennessee Tobacco Quitline Business Card (Spanish)

Model Policies – Public Health Law Center

Tobacco-Free Policy Guidance for Worksites

Tobacco-Free Policy Guidance for Hospitals

Tobacco-Free Policy Guidance for Colleges and Universities

Tobacco-Free Policy Guidance for Landlords

Tennessee Tobacco Quitline Fax Referral Service Enrollment Form – Use this form to refer patients to the Tennessee Tobacco Quitline.

Health Effects of Cigarettes: Reproductive Health (CDC) – Learn how smoking impacts reproductive health.

Helping Smokers Quit: A Guide for Nurses – A practical guide to support patients with quitting tobacco.

Smoking Cessation Clinical Practice Guidelines (NIH) – Evidence-based recommendations for treating tobacco dependence.

Create Your Own Tobacco Cessation Protocols (Million Hearts) – Resources to develop customized cessation protocols.

Resources for Parents on Tobacco and Nicotine Prevention

Talking with Youth About Tobacco and Nicotine

Talking with youth about tobacco and vaping can be challenging, but early, open conversations make a difference. Tennessee teens are using e-cigarettes at alarming rates, putting them at risk of nicotine addiction. Explore resources to help your child quit and learn the facts about vaping.

Help Your Teen Understand the Risks

Nicotine is addictive. It is the substance that hooks people to cigarettes, cigars, smokeless tobacco, hookah, most e-cigarettes, pouches, gum, and lozenges.

Health risks of tobacco and nicotine:

• Tobacco smoke contains thousands of harmful chemicals that cause cancer, COPD, and other fatal diseases.
• E-cigarette aerosol is not harmless. It contains nicotine, ultrafine particles, cancer-causing chemicals, heavy metals, and flavorings linked to lung disease.
• Nicotine harms the developing brain (up to age 25), impacting memory, learning, attention, and increasing risk for future addiction.
• Youth who vape are more likely to smoke regular cigarettes later.

Diseases caused by smoking include: cancer, heart disease, stroke, COPD, diabetes, tuberculosis, eye diseases, and immune disorders like rheumatoid arthritis.

Resources for Quitting

SmokeFree Teen – Tools and tips

SmokeFree.gov – Make a quit plan

American Lung Association – Youth quitting support

4 Things Parents Need to Know About JUUL

Become An EX

TN Quitline – Call, text, or online coaching

The Center for Black Health & Equity – Community health resources

TN Tobacco Retailer Education Guide – Information for retailers

Is Vaping Safe?

E-cigarettes, also called electronic nicotine delivery systems (ENDS), include vapes, vape pens, mods, and tanks. Youth use remains high, with about 1 in 5 high school students reporting e-cigarette use in 2020. Disposable devices are especially popular due to flavor exemptions from federal restrictions. Nearly all youth who vape (97%) use flavored products.

Health Risks of E-Cigarettes

Most e-cigarettes contain nicotine, a highly addictive substance that harms brain development in adolescents and young adults. Nicotine use under age 25 can impact learning, memory, and attention while increasing the risk of future addiction.

E-cigarette aerosol is not harmless. It can contain:

• Ultrafine particles that reach deep into the lungs
• Flavorings such as diacetyl, linked to lung disease (“popcorn lung”)
• Volatile organic compounds
• Cancer-causing chemicals
• Heavy metals like nickel, tin, and lead

Exposure can harm both users and bystanders. Youth who use e-cigarettes may also be more likely to smoke cigarettes later in life.

Additional Dangers

• EVALI Outbreak: In 2019, Tennessee reported its first vaping-related death and at least 57 cases of lung injury linked to e-cigarette use.
• Injuries & Poisoning: Defective batteries have caused fires and explosions, often during charging. Children and adults have been poisoned by swallowing, inhaling, or absorbing vape liquids.
• Mental Health: Some teens use vaping to cope with stress, but nicotine withdrawal actually increases anxiety. SmokeFreeTeen provides safe strategies for stress management.

Support for Parents to Help Teens Quit Vaping

DoTheVapeTalk – Helps Parents Start a Critical Conversation

EX Program – How to help your child stop vaping

Vaping and Marijuana: Key facts for parents and teens

References

1. "Disposable e-cigarette's vague new flavor names attempt to evade regulation." Truth Initiative, June 7, 2021. www.truthinitiative.org
2. Goniewicz ML, Gupta R, Lee YH, et al. Nicotine levels in electronic cigarette refill solutions: a comparative analysis of products from the U.S., Korea, and Poland. Int J Drug Policy. 2015;26(6):583–588.
3. Quick Facts on the Risks of E-cigarettes for Kids, Teens, and Young Adults.
4. What are the health effects of using e-cigarettes?

Emerging Tobacco Products

Emerging tobacco products are new nicotine-delivery products that may or may not contain tobacco. Many are flavored and packaged to appeal to youth, including e-cigarettes (like JUUL), heat-not-burn products (like IQOS), pouches (like Zyn), lozenges (like Nicorette), and nicotine gum (like Lucy).

These products are easy to conceal, dissolve under the tongue, or are chewed. Non-tobacco products are not safer than cigarettes and can still cause nicotine addiction, cancer, lung problems, and other health issues. Risks vary depending on nicotine levels and other toxins.

Why awareness matters: Teens often find ways to hide use of these products. Parents and educators should know what to look for, understand the risks, and seek help if a child or teen is using these products.

If your child or teen uses any of these products, they may be experimenting or addicted. Support is available through resources such as Helping Your Teen Quit. E-cigarettes have been the most commonly used tobacco product among youth since 2014.

E-Cigarettes and Youth

E-cigarettes, also called vapes, e-cigs, ENDS, vape pens, mods, and e-hookahs, have been the most commonly used tobacco product among youth since 2014. Some e-cigarettes resemble everyday items such as pens, USB drives, or candy dispensers, making them easy to conceal.

Many young people believe vaping is safer than smoking, but e-cigarettes produce an aerosol containing toxic chemicals, including heavy metals and carcinogens. This toxic exposure can harm nearly every organ in the body and may increase cancer risk. For a full list of chemicals in e-cigarettes, visit the American Lung Association.

Most e-cigarettes contain nicotine—the addictive drug found in cigarettes—sometimes at levels equivalent to a full pack of 20 cigarettes per pod. Flavored options like strawberry, watermelon, and cool mint appeal to youth. Many teens vape multiple pods per day, greatly increasing their nicotine intake.

Federal and state flavor bans limit some e-cigarette products, but loopholes allow menthol, tobacco flavors, and certain disposable or refillable devices to remain available. Marketing through social media, peers, and influencers further entices young people to use these products.

Oral Nicotine Products

Oral nicotine products, including nicotine pouches, lozenges, and gum, come in many flavors, varying nicotine strengths, and are often marketed as tobacco-free alternatives. Despite marketing claims, these products still contain nicotine, which is harmful to young people and highly addictive. Some use synthetic nicotine, which may mislead users into thinking it is safer.

Nicotine Pouches: Small, spit-free bags placed under the upper lip deliver nicotine without chewing or producing saliva. These pouches are easy to conceal and marketed as safer alternatives, but they still pose risks of addiction and oral, esophageal, and pancreatic cancers.

Nicotine Lozenges: Lozenges dissolve slowly in the mouth, providing nicotine to reduce withdrawal symptoms. Their candy-like appearance and easy concealment increase risk for youth. Long-term use may contribute to oral, esophageal, and stomach cancers.

Nicotine Gum: Gum delivers nicotine in a chewable form and comes in various flavors. It is intended for adults but is increasingly used by youth. Nicotine use during adolescence can disrupt brain development, increase susceptibility to addiction, and lead to lifetime dependence.

All oral nicotine products are addictive and pose significant health risks. Early exposure increases the likelihood of future tobacco use, including cigarettes and e-cigarettes.

Synthetic Nicotine Products

A new wave of synthetic nicotine products is emerging, raising health and regulatory concerns as youth vaping continues at high levels. These products, often marketed as tobacco-free, come in flavors that attract young people and have not undergone FDA regulatory review.

While the long-term health effects of synthetic nicotine are still unknown, these products are addictive and can harm the developing brain. The tobacco industry markets them as less dangerous than smoking, but they pose similar risks and may lead youth who would never have tried cigarettes to become addicted.

Heat-Not-Burn Tobacco Products

Heat-not-burn tobacco products, also called non-combusted cigarettes, heat real tobacco to produce an inhalable aerosol instead of burning it like traditional cigarettes. These products, sometimes called heatsticks, look like small cigarettes and are inserted into the device to be heated but not ignited.

The FDA has authorized their sale in the United States, but this does not mean they are safe or “FDA approved.” There are no safe tobacco products, and these items can still pose health risks.

Concept Flavors

Concept flavors are vague, non-descriptive names on tobacco products, such as “Marigold,” “Arctic,” or “Solar,” that do not explicitly identify a flavor but are still flavored. These products are often more heavily flavored than traditional flavored tobacco products.

Concept flavors are part of marketing tactics designed to circumvent flavor restrictions and appeal to youth. They also make it challenging for enforcement agencies to determine whether a product meets legal definitions of flavored tobacco.

Talk to Your Children About Tobbacco

Tobacco and nicotine products are easy for youth to use without detection. Colorful packaging and flavors make them appealing.

Parents and caregivers should talk with children about the risks, encourage a smoke-free lifestyle, and support quitting if they are using these products. Learn more at Helping Your Teen Quit.

References:

• CDC, E-Cigarette Use Among Youth. Link
• Truth Initiative, Oral nicotine products entice customers with “tobacco-free” claims. Link
• Truth Initiative, Synthetic Nicotine Products. Link
• Truth Initiative, Concept Flavors, and Youth Use. Link

• Kill The Can – Online community for people quitting smokeless tobacco.
• Tobacco Cessation Directory (2015) – Find local and national quit resources.
• Women and Smoking (2015) – Learn how tobacco use affects women’s health.
• How Does Smoking Harm My Baby? (2015) – Information for expectant parents.
• Centers for Disease Control and Prevention (CDC) – Smoking and Tobacco Use – National data and resources.
• Is Chewing Tobacco Safe? (2015) – Health risks of smokeless tobacco.
• How Can I Avoid Weight Gain if I Quit Smoking? (2015) – Tips for maintaining a healthy lifestyle.
• How Can I Help Someone Stay Smoke-Free? (2015) – Guidance for supporting others who are quitting.
• Quitting: It’s Not Easy and It Takes Time (2015) – What to expect on your quit journey.
• How to Talk to Teens About Smoking (2015) – Conversation starters for parents and mentors.
• What Happens When I Become Addicted to Nicotine? (2015) – Understanding nicotine dependence.
• What Happens When I Stop Smoking? (2015) – Benefits and changes after quitting.
• Is Cigar Smoking Safe? (2015) – The risks of cigar use.
• Teens: Be a Leader, Stop Smoking (2015) – Resources designed for youth leaders.
• The Facts Now – Exposing Big Tobacco’s Lies – Campaign challenging tobacco industry messaging.