Last Updated: February 2020 Author: Tobacco Control Program, Department of Health
This is a newer indicator for the performance dashboard because of the need to understand how many Vermonters are using one or more tobacco products. In 2012, 12% of adults used smokeless or other tobacco products. In 2014 and again in 2016, the rate is 11%, although this is not a significant decrease from 2012. Our target is to reach 9% or lower by 2020. The Tobacco Control Program had planned to update this measure in 2018 or 2019 through the fielding of an Adult Tobacco Survey (ATS). Due to limited bids that met the criteria and budget of the program, the ATS has not yet been fielded. The Health Department's Surveillance Division issued a Request for Information in 2019; using these results, the program can move forth with efforts to secure a contract for fielding the ATS in the fall of 2020.
Examples of smokeless and other tobacco products include chewing tobacco, snuff, snus, cigar products and e-cigarettes, defined as tobacco substitutes in Vermont statute. Adult smokers are much more likely to use smokeless and other tobacco products than non-smokers. For example, in 2016 among adult smokers, 13% use e-cigarettes compared to 3% of non-smokers. In 2014, 15% of adult smokers reported using e-cigarettes compared to 1% of non-smokers.
In the 2016 Adult Tobacco Survey Report, among tobacco products other than cigarettes, cigar products (6%) and electronic cigarettes, commonly referred to as e-cigarettes (4%), are the most commonly used. Two percent of Vermont adults use smokeless tobacco or another form of tobacco product other than cigarettes. Overall, 11% of Vermont adults use at least one non-cigarette tobacco product. The prevalence of OTP use is significantly higher among current smokers than non-smokers. This is especially evident for cigar product and e-cigarette use.
There was a notable increase in the perceived harm of electronic cigarettes from 2014 to 2016. In 2016, 63% of Vermont adults believe that e-cigarettes are very or somewhat harmful to one's health. This is significantly more than the 52% who perceived e-cigarettes to be very or somewhat harmful in 2014. This change mostly occurred among Vermont adults who did not have an opinion or were not sure about the harm of e-cigarettes in 2014. There was no significant difference in the use of e-cigarettes from 2014 to 2016.
Vermont males are significantly more likely than females to report use of smokeless tobacco. Young adults in Vermont, those between 18 to 24-year-old, report significantly higher rates compared to their counterparts in the U.S. Adult use of smokeless tobacco in Vermont decreases with age, with those 45 and older less likely to report use than those 18-24 years old. Smokeless tobacco use is also lower among those with higher levels of education.
Smokeless tobacco is associated with gum disease, tooth decay and tooth loss and like cigarettes can lead to nicotine addiction. Use of smokeless tobacco can cause cancers of the mouth, esophagus, and the pancreas, increases the risk for early delivery and stillbirth when used during pregnancy, and may increase the risk for death from heart disease and stroke (CDC). Cigar smoke contains more cancer-causing chemicals, including tar, than cigarettes and is possibly more toxic (National Cancer Institute). Given their larger size they can also cause overall higher exposure time to toxins. E-cigarettes are recognized as containing fewer toxic chemicals than cigarettes (CDC) but they emit particulates, some of which may be harmful. E-cigarettes often contain nicotine and are not recognized as a proven cessation device by the FDA.