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Vermonters are healthy

Vermonters are healthy

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Vermonters are healthy

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VERMONTERS ARE HEALTHY

VERMONTERS ARE HEALTHY

% of adults who smoke cigarettes

15%2018

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Story Behind the Curve

Last Updated: March 3, 2020

Author: Tobacco Control Program, Vermont Department of Health


Adult smoking prevalence in Vermont was 17% in 2015, which had been a significant reduction from 2011. In 2018 the prevalence dropped further to 15%, putting Vermont at slightly lower than the national rate of 16%. According to the Campaign for Tobacco Free Kids, among all states Vermont ranks 10th lowest in adult smoking prevalence. 

In the last 20 years in Vermont, there has been a gradual decline in smoking from a high of 24% in 1996. Compared to national rates, Vermont shows a significantly higher smoking rate among racial/ethnic minorities; Vermonters who make less than $25,000 in annual income; and those who have less than a high school degree (Tobacco Use Among Adults and Youth in Vermont and United States). Vermont is one of the most rural states in the nation; research shows that tobacco use is higher among rural populations, adult, youth and pregnant women.

Vermont has a robust and long history in tobacco control and prevention. In 1987 Vermont was the first state to implement a Smoke-free workplace law, and in 1995 Vermont public schools became smoke-free. In 2001 Vermont established a comprehensive Tobacco Control Program and the Vermont Tobacco Evaluation and Review Board, both funded by the Master Settlement Agreement dollars. The State also began offering an evidence-based state Quitline that is accessible and staffed by trained counselors. The program also implemented counter marketing to raise awareness about the dangers of tobacco and resources to quit. The comprehensive approach of the program expanded to include collaboration with Medicaid and the Blueprint for Health, Quit Online and text services, and mass reach media to provide motivation to quit.  

Vermont has made significant progress in passing policies that protect from hazardous secondhand smoke, reduce youth access and contribute to people quitting. In 2012 the Vermont Tobacco Evaluation and Review Board and others worked on establishing price parity among cigarettes and other tobacco products which helps to prevent consumers switching to another harmful product when the price of cigarettes is increased, and updated to include tobacco substitutes now considered tobacco products and taxed at 92% wholesale price as of July 1, 2019. Other protective policies passed in the past several years include restricting smoking in cars when children under the age of 8 are present; restricting use of e-cigarettes where lit tobacco products are not allowed; requiring all tobacco products be safely stored behind the counter or in a locked case, and increasing the legal age to purchase tobacco products to 21 in addition to restricting online purchase of vaping products to only those with a wholesale license. 

 

Partners
    • National Jewish Health: The program's contractor which provides the Quitline and Quit Online in English, Spanish and other languages per translation services, an incentive-based pregnancy protocol, and text messaging support.
    • Department Vermont Health Access: The Vermont Medicaid office collaborates with the program on expanding and promoting the tobacco treatment benefits. The Medicaid tobacco benefit includes brief or intermediate one-on-one and group counseling and approved nicotine replacement therapies that when combined with counseling doubles the likelihood of a successful quit.
    • Blueprint for Health Quit Partner Program: A network of regional coordinators and tobacco treatment specialists that are supported by the Blueprint and the Health Department's Tobacco Control and Prevention Program. In every health service area of the state are tobacco treatment specialists serving in hospital, clinical and community settings. Quit Partners use the Fresh Start program, a 4 session format which provides peer support, skill based learning and tips for managing stress.
    • Substance Misuse Prevention Council (SMPC): A Governor appointed board dedicated to a statewide comprehensive and coordinated approach to prevention of all substances to improve the health and well-being of Vermonters.
    • Coalition for Tobacco-free Vermont: A statewide coalition comprised of members of health voluntary organizations (Lung, Cancer, Heart) and community tobacco coalitions. The Coalition works to advance strong tobacco control and prevention policies to create a Tobacco-free Vermont.
What Works

Population-wide interventions that change societal environments and norms related to tobacco use - including increases in the unit price of tobacco products, comprehensive smoke-free policies, and hard-hitting media campaigns - increase tobacco cessation by motivating tobacco users to quit and making it easier for them to do so. CDC Best Practices for Comprehensive Tobacco Control Programs gives four specific recommendations for promoting quitting, addressing tobacco use among adults and shifting to tobacco-free social norms:

  • promote health systems change,
  • expand insurance coverage and utilization of insurance coverage,
  • support state Quitline capacity, and,
  • state and local policies that influence and support behavior change.

Vermont’s Tobacco Control Program implements these strategies within the current funding granted by the CDC and the State of Vermont. The program is seeking to expand its efforts and efficacy in its health systems engagement with other insurers to complement the accomplishments it has realized for expanding and promoting tobacco benefits in Medicaid. In working with Medicaid, CPT codes were turned on in January 2014 allowing medical practitioners and other providers to bill for reimbursement of cessation counseling services. In 2014 and 2015  mailings were sent to Medicaid beneficiaries and providers alike, which promoted the free tobacco cessation resources available to Vermont’s smokers. This mailing resulted in a surge of Quit Tool Kit orders and an increase in the use of the CPT codes for reimbursing tobacco treatment counseling.

The Tobacco Program also advocated for including tobacco as a reporting measure in the Accountable Care Organizations operating in Vermont. The Program has been working on supporting more accessible and mobile-friendly cessation resources including text to better reach and support Vermonters seeking to use 802Quits. The program is also implementing a pregnancy protocol through the Quitline (1-800-Quit-Now) that offers $5 and $10 gift cards for each counseling session. Airing mass reach media is also an important component of the comprehensive program that effectively reaches smokers and encourages them to contemplate and/or take action steps towards quitting.

Strategy

The Tobacco Control Program is implementing new initiatives and methodologies to reach, treat, and assess our progress in reducing tobacco use among adults, including those with smoking prevalence:

  • A multi-year initiative to create a Culture of Health in behavioral health centers that receive state funding. Many of the state's designated agencies have become or are in the process of becoming tobacco-free campuses and incorporating tobacco into treatment strategies. The Tobacco Control Program partners with the Department of Mental Health and the Division of Alcohol and Substance Abuse Prevention to supply technical assistance, training, webinars and tobacco-free signage.
  • The Program is in year 4 of a four-year CDC Quitline Enhancement grant to ensure cessation benefits are free and accessible to all Vermonters and to maintain our Quitline capacity in serving smokers in Vermont; federal funding ends in 2018. 
  • Implementation of legislation passed in Act 135 that strengthens social norms around tobacco and establishes more smoke-free environments, including cars and around state buildings, creating healthier environments for children and for adults trying to quit smoking.
  • Funding of community grantees who work to educate on tobacco to youth, stakeholders and decisionmakers on why it is important to restrict access to tobacco by children and to increase the number and type of tobacco and smoke free environments. Successes include smoke and tobacco-free college and hospital campuses, parks, beaches, and community gathering spots across Vermont.


Similar to statewide efforts, local partners are using data to drive local strategy. For regional data on Tobacco indicators, check out our Public Health Data Explorer.

Why Is This Important?

Tobacco use is the #1 preventable cause of death. In Vermont, smoking costs approximately $348 million in medical expenses and results in an estimated 1,000 smoking-related deaths each year. 10,000 kids now under 18 and alive in Vermont will ultimately die prematurely from smoking. Countless other lives, including those of friends and family members, are impacted by the negative effects of tobacco use and secondhand smoke exposure. Reducing tobacco use and the chronic disease and mortality it causes is one of CDC's Winnable Battles.


Notes on Methodology

Data is updated as it becomes available and timing may vary by data source. For more information about this indicator, click here.

This indicator is age-adjusted to the 2000 U.S. standard population. In U.S. data, age adjustment is used for comparison of regions with varying age breakdowns. In order to remain consistent with the methods of comparison at a national level, some statistics in Vermont were age adjusted. In cases where age adjustment was noted as being part of the statistical analysis, the estimates were adjusted based on the proportional age breakdowns of the U.S. population in 2000. For more detailed information on age adjustment visit /www.cdc.gov/nchs/data/statnt/statnt20.pdf.

Due to BRFSS weighting methodology changes beginning in 2011, comparisons between data collected in 2011 and later and that from 2010 and earlier should be made with caution. Differences between data from 2011 forward and earlier years may be due to methodological changes, rather than changes in opinion or behavior.

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