I grew up cooking shoulders and the occasional whole pig, so butts are kind of new to me in that I've been cooking them for less than 20 years.
The biggest change is in the concept of "pulled pork". Traditionally we chop our pork in NC, except for a true whole hog pig pickin' where people just grab a handful (or tong full) and go on their way. Nobody pulled pork in NC before the Food Network started talking about it. Chopped, coarse chopped, and sliced were your choices.
For pork to be pulled you'll need to cook to 190+. For chopped you can stop anywhere above 180* and get good results and slightly better yield if that's important.
In the eastern part of the state they'll add crushed red pepper and vinegar as they chop. Some places add a little Texas Pete too. Any table sauce is just vinegar with some salt and cayenne pepper added.
Piedmont(or Lexington) style will use a finishing sauce like Smokin's added after chopping, served hot on the meat. There might be a stronger vinegar based peppery sauce on the table for those that want it.
Also, traditional wood fired pits usually cook hotter than the 225-250* we discuss most often here, giving the meat little smoke flavor from the wood, but with a more porky flavor coming from the fat drippings. The butts from a CS are really a whole different animal in that they can be as smokey as you want. The crust of a butt cooked in a CS differs a lot from the dark amber colored glaze-like finish of a pit cooked butt. I've yet to have a preference for one vs the other that lasted for more than 3 minutes.
Here are some cooked over hickory coals that kind of give you an idea of the difference in color.
