Last Updated: October 2023

Author: Tobacco Control Program, Vermont Department of Health

Annual investment in comprehensive tobacco control is instrumental for reducing the deaths and disease burden caused by tobacco: 1,000 smoking attributable deaths in Vermont each year. A well-funded tobacco control program is cited in CDC's 2014 Best Practices for Comprehensive Tobacco Control Programs as a strategy to reduce the state's smoking prevalence. State Tobacco Control Programs have documented return on investments of between 2:1 (cardiovascular hospital admissions among Medicaid population in Massachusetts over a three-year period) and 50:1 (health care costs in California over a 10-year period). 

The Centers for Disease Control and Prevention (CDC) published in the 2014 Guide both minimum and recommended funding levels for each of the fifty states it funds to reduce and prevent tobacco use and burden. For Vermont, the minimum level for a comprehensive program is $6.1 million while the recommended amount is $8.4 million. The Vermont Tobacco Control Program’s funding has steadily descreased since 2020 from 62% to 43% of the recommended total budget level.

Through the efforts of the Vermont Legislature, the state's leadership, the former Vermont Tobacco Evaluation and Review Board and the Coalition for a Tobacco-free Vermont, Vermont's program has been awarded funds from several sources including the Tobacco Master Settlement Agreement (MSA) and Global Commitment which helps achieve a funding level and impact that is higher than if solely reliant on federal funds.

The state has continued its investment in tobacco control and prevention at a maintenance level, which the Department's tobacco program uses to tackle the vaping epidemic among youth, serve thousands of Vermonters with free cessation information and assistance, equip partners and 11 community grantees to reach vulnerable populations with tobacco education and resources, and strive for reducing exposure to dangerous secondhand smoke. However, the Tobacco Program is not as impactful as it could be if it were funded at the recommended minimum level by the CDC.

Coalition for Tobacco-Free Vermont: Through advocacy and engagement, promotes and assists in the implementation of policies and programs at the state and local levels to reduce tobacco use and its impact on the health and economic wellbeing of Vermonters.

Department of Liquor and Lottery: The Vermont Department of Liquor & Lottery provides a regulatory framework for the responsible sale and consumption of alcohol, tobacco, and gaming entertainment, ensuring public safety and contributing 100% of profits to Vermont communities through the General and Education funds. The DLL conducts annual youth enforcement checks and retail audits.

Vermont Department of Health Access: As the department that oversees the benefits provided to Vermonters served by Medicaid insurance, DVHA partners with the VTCP on the tobacco benefit and its utilization by providers and beneficiaries.

Centers for Disease Control and Prevention Office of Smoking and Health (OSH): is the lead federal agency for comprehensive tobacco prevention and control. OSH is a division within the National Center for Chronic Disease Prevention and Health Promotion, and funds each state and US territories for tobacco control and prevention activities.

As stated by the CDC in the 2014 Best Practices Guide, the primary objectives of the recommended statewide comprehensive tobacco control program are to reduce tobacco use and the individual and societal burden of tobacco-related disease and death. Research indicates that the more a state spends on comprehensive tobacco programs, the greater the reductions in smoking. It is also found that the longer a States invests, the greater the impact and the more quickly it can be seen. Over the past ten years, the program and partners, with the commitment of leadership and the legislature, has reduced adult smoking from 20 percent to 16 percent (BRFSS 2021) and youth smoking from 18 percent to 5 percent (YRBS 2021). Unfortunately, during this same time period we have seen the rate of youth vaping increase from 15 percent to 16 percent (YRBS 2021). 

In FY2024 the Tobacco Program will:

• Continue implementation of several financial incentives for completion of counseling sessions available through the 802Quits program. Incentives and tailored protocols are offered for Medicaid members, those who are pregnant, Vermonters with mental health conditions and those that use menthol products.
• Fund and promote the youth tobacco cessation text-based program, My Life My Quit. 
• Complete and disseminate the Retail Audit report and dashboard that highlights disparities seen in tobacco access and retailer density around schools using the 2014, 2017-2018, and the new 2022 audit data compiled by the Department of Liquor and Lottery.
• Coordinate strategies including mass reach and digital media, public education and policy to address the vaping epidemic among middle and high school youth.
• Disseminate the Adult Tobacco Survey results to understand attitudes and behaviors of Vermonters and use the results to inform tobacco control strategies.
• Fund 11 community coalitions who work at the local level to support policy efforts and school wellness; educate on emerging tobacco control issues; advance smoke- and tobacco-free spaces (parks, downtowns, around municipal buildings), link clinics with 802Quits and promote cessation services.
• Coordinate middle and high school youth groups, VKAT and OVX, across the state. Fund partners working to increase youth and young adult assets and inclusivity including with Vermont Afterschool and Outright Vermont. 
• Disseminate data on trends seen in youth and adult tobacco use and the best strategies to improve Vermonter’s health and cost savings. Discuss with partners and at meetings how a well-funded program contributes to desired economic and public health outcomes including community education and engagement, clinic-based tobacco treatment, clinician and community referrals to Vermont’s suite of free services at 802Quits, and mass reach media to educate and encourage quitting.