Last Updated: November 2022

Author: Tobacco Control Program, Vermont Department of Health

All states run a Quitline with support from the CDC and in Vermont, with state funding. Quitlines are shown to be effective at helping people to quit and in Vermont, the Quitline is available 24/7, offers multiple sessions of counseling and free access to nicotine replacement therapy (NRT) shipped to participants' homes. When counseling and NRT are used together it more than doubles the chances of quit success.

The curve represents the number of callers who register for the Quitline. Tracking the number of Vermont smokers who register for the Quitline is important for assessing the utilization of the Vermont Tobacco Control Program's (VTCP) cessation programs and services. It is necessary to monitor how well the media and promotion efforts the program implements are driving smokers to use the Quitline.

• The Tobacco Control Program’s Annual Report FY20 highlights the outcomes of our cessation work:
  • 802Quits is an evidence-based statewide program that offers 24/7 cessation support through the Quitline, Quit Online and Quit Partners (Quit in Person) programs, serving 4,747 in FY20.
  • In 2020, 94% of quitline registrants had made at least one quit attempt in the past.
  • Four in five Vermonters of color made a quit attempt.
  • The program has made promoting cessation among priority populations a goal, including pregnant, low income, those with mental health disorders and LGBTQ. In FY20:
    • There was nearly a 13% increase in LGBTQ registrants from 2019.
    • More than a third of quitline registrants are Medicaid insured.

Campaign promotions especially using ads broadcast on television are instrumental to driving people to a Quitline. Every year the program airs a minimum of three campaigns designed to reach vulnerable Vermonters who are impacted by tobacco use. These include those with lower incomes and education. Ads include CDC’s Quit Tips campaign television ads, Vermont Quit Partner ads, and digital media. During periods when mass reach cessation campaigns are not occurring, digital media help reduce the dips in Quitline registrants.

Smoking cessation and prevention of initiation of smoking can help reduce the risk of onset of many chronic diseases including Type II diabetes. Smoking cessation can also help reduce complications from diabetes and improve self-management.

In FY20, financial incentives were added to the suite of quitline services for specific populations, to increase engagement and utilzation of the quitline by Vermonters.

• National Jewish Health- The program's quitline contractor who provides the quitline and quit online services and sends the program monthly 802Quits reports.
• Rinck Advertising- The program's media sub-contractor who supports promotional efforts and the 802Quits website. 
• Department Vermont Health Access- The Vermont Medicaid office who collaborates with the program on expanding and promoting the cessation benefit and 802Quits resources for Medicaid beneficiaries.
  • Blueprint for Health- The Vermont Blueprint for Health designs community-led strategies for improving health and well-being.
• CDC­- The program uses CDC's Tips from Former Smokers in mass-reach health communications

Hard-hitting and emotionally powerful ads like those from CDC's Tips have been shown to increase cessation activity, especially among lower income tobacco users who represent the majority of smokers in Vermont. The call to action in the ads used in Vermont has directed residents toward the Quitline. Quitlines and the promotion of them through mass-reach health communication interventions are best practice strategies in a comprehensive tobacco program. VTCP receives weekly, monthly, and quarterly Vermont Quitline data from its vendor. The program's current strategy is to engage providers to encourage referrals to the Quitline in addition to providing in-clinic counseling. Continuing and enhancing these efforts will work to turn the curve.

Reducing smoking is important for alleviating chronic disease burden and prevalence. Smoking effects tissues that make up the musculoskeletal system, increasing the risk of injury and disease including a higher risk of low back pain and rheumatoid arthritis. Smoking cessation may help to reduce the prevalence and severity of arthritis among Vermonters.

Smoking increases risk of developing osteoporosis — a weakness of bone that causes fractures. Elderly smokers are 30% to 40% more likely to break their hips than their non-smoking counterparts. Smoking weakens bones in several ways, including:

• Studies have shown that smoking reduces the blood supply to bones, just as it does to many other body tissues.
• The nicotine in cigarettes slows the production of bone-forming cells (osteoblasts) so that they make less bone.
• Smoking decreases the absorption of calcium from the diet. Calcium is necessary for bone mineralization, and with less bone mineral, smokers develop fragile bones (osteoporosis).
• Smoking seems to break down estrogen in the body more quickly. Estrogen is important to build and maintain a strong skeleton in women and men.

• In FY23 the program will:
  • analyze the efficacy of its promotional efforts which includes tracking the Quitline data.
  • promote the Quitline through CDC Tips, locally produced advertisements, digital media, social media engagement, and mailings. The VTCP is working with several other states to learn and apply their approaches to reach vulnerable populations, including using a sympathetic approach.
  • implement and promote new 802Quits protocols, aimed at youth and young adults, and behavioral health.
  • increase provider awareness and utilization of 802Quits resources.
  • explore with Quitline and media partners cost effective ways for improving awareness of the Quitline, utilization of supports like text programming, and changing the mix of media outreach to include modes that may more effectively reach Vermont smokers.
  • collaborate with partners, such as the Pride Center, to promote Quitline utilization by populations experiencing disparities.
  • join other states in supporting a pilot with National Jewish Health to develop and test a protocol to enhance Quitline services for those callers experiencing anxiety and depression.