Last Updated: May 8, 2019

Author: You First Program, Vermont Department of Health

This performance measure helps us assess performance based on quantity; a higher percentage is better.

As of 2015, 17% of Vermont adults smoke cigarettes with 57% of tobacco users attempting to quit in the last year.

You First is a prevention program funded by the Centers for Disease Control (CDC) that works to remove barriers that may prevent women from getting important health screenings related to breast, cervical and heart health.One of the ways that You First works to decrease cardiovascular disease in Vermont women is to refer them to tobacco cessation programs.This measure is looking only at members screened during the quarter and not the entire You First population.

You First originally served women at or below 250% of the Federal Poverty Level who were uninsured or underinsured.In the spring of 2015, the CDC granted VDH permission to enroll female Medicaid beneficiaries between the ages of 40 – 64 in Ladies First.This expansion allowed outreach to a larger pool potential members as well as possibly provide increased referrals to tobacco cessation services. We are proactive in offering 802Quits referrals to members who smoke.When applicants to the program identify as smokers, they are immediately asked if they want an 802Quits referral. If yes, the referral happens right away and is captured in the database even before any other program participation occurs. If no, the member is still reminded about this program option at every point of contact.This means that if a member who smokes enrolls in an LSP/HC, she will still be reminded that 802Quits is available to her as she makes progress along the readiness-to-change spectrum.Currently our Bennington based clinic champion is a certified Tobacco Treatment Specialist who routinely offers tobacco cessation sessions with members who smoke.

Currently, all women who apply to the You First program are asked if they smoke. If they do, they are asked if they would like a referral to the Vermont tobacco cessation program, 802Quits. Women who indicate they would like a referral receive the referral. Women who are not ready for this behavior change are sent information about 802Quits, in case they decide later to use the program. At present, 38% of You First members who smoke are referred to 802Quits.

As noted above, a member who uses tobacco may initially decline the 802Quits referral. However, once she receives her cardiovascular risk factor screening, the You First Lifestyle Program Coordinator will again ask her if she is ready to quit. Some members who are not ready to quit upon first enrolling in the program become more ready after considering it for a few weeks or receiving their risk factor results. If the member is still not ready to quit after her screening, the Lifestyle Program Coordinator will ask if she can be contacted again in several weeks to revisit the possibility.

The You First program collaborates with the Tobacco Cessation program, 802Quits, located within the Division of Health Promotion and Disease Prevention at the Vermont Department of Health.The 802Quits program offers three methods for cessation counseling: in person, via telephone, and online.

The 802Quits program prioritizes those Vermonters who are ready to set a 30 day quit plan.In order to reach the women most likely to use 802Quits' services, theYou First program works with women either contemplating change or ready to take action using the Readiness to Quit Ladder tool from The Tobacco Treatment Handbook: A Guide to Best Practices.

The You First program will do the following to increase the % of members who smoke that accept a referral to tobacco cessation services.  We work closely with the Tobacco Cessation Specialist to track the number of You First members who enroll in 802Quits as a result of the referral made and their progress.