Last Updated: October 2023

Author: Tobacco Control Program

In 1995, the prevalence of youth smokers in Vermont was 40%. In 2019, it was 7% which is a historic low. and exceeds our Healthy Vermonter 2020 goal! This substantial decrease in youth smoking reflects the efforts of multiple partners using a coordinated set of evidence-based strategies.

The Tobacco Control Program in collaboration with its partners including advocates, health voluntary organizations, the Tobacco Evaluation and Review Board (up through 2019) and legislators, have worked diligently to reduce tobacco’s harm to youth. Achievements since the early 90’s include prohibiting all tobacco sales to minors, creating tobacco-free schools and grounds, ending vending machine sales and establishing Vermont Kids Against Tobacco (VKAT) youth coalition effort. Subsequently, in addition to tobacco tax increases and other restrictions passed in the Vermont legislature, the current prevalence of youth smoking is 67% less than it was twenty years ago. While establishing Vermont’s Healthy People 2020 goals, the program adopted the national benchmark in setting the target goal of 10% youth prevalence.

Multiple efforts have contributed to the declining prevalence in the last 20 years. Since 2009, Vermont’s Tobacco Control Program has systematized the technical assistance and training provided to youth and community coalitions in order to increase awareness and implementation strategies per best practice guidelines. An important component of prevention is to shift social norms to tobacco-free, raise awareness of tobacco’s danger and impact on health, reduce the impact of tobacco advertising on youth initiation, and create healthy environments which support tobacco-free lifestyles. The program added Our Voices Xposed (OVX) in 2001 to mobilize high school youth in tobacco control issues. Tobacco programs assess their progress in prevention through reducing initiation among youth by monitoring the proportion that smoke their first whole cigarette by the age of 13. Vermont has seen a significant decline in youth smoking initiation before the age of 13. Starting tobacco use early increases risk for future smoking and substance use. 

A continued emphasis for youth engagement through VKAT and OVX is to engage community members around tobacco issues aided by collaborating with the Agency of Education.  In 2015, the program implemented a successful youth engagement initiative titled Free My Ride, which focused on increasing awareness of the dangers posed by smoking in vehicles when children are present. In 2016, OVX youth brought attention to the sharp rise in e-cigarette use by teens. The program has implemented Down and Dirty as a method of engaging rural youth with tobacco-free branding and an educational campaign CounterBalance to bring attention to the dangers of flavors and how they are used to initiate youth to tobacco. Since 2017, community grantees and youth have been collecting concern cards, spoke to the media about flavored tobacco, and participated in a photo voice project highlighting what tobacco access and promotion looks like in their communities.

The program has been identifying and tackling issues that detrimentally impact youth’s vulnerability to tobacco. Youth efforts have focused on the need for smoke-free places like parks, beaches, school grounds and cars. Over the past several years the program has worked with advocates and partners on tightening youth’s access and exposure to both tobacco and tobacco substitutes culminating in Act 135. This piece of legislation bans the use of e-cigarettes and paraphernalia, both of which can be pathways to smoking, on school grounds and at school events. Act 135 also included bans on smoking cigarettes in cars with children under 8 years old. In 2016 Act 108 was passed to restrict the use of e-cigarettes wherever lit tobacco products are banned. These bills are key to protecting health and safeguarding social norms. In 2019 the Vermont Legislature passed a set of prevention acts to ban e-cigarette sales online without a wholesale license, create a tax on e-cigarettes (defined as tobacco substitutes), and raised from 18 to 21 the legal age to purchase tobacco products. 

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.

Reducing tobacco use is part of Healthy Vermonters 2020 (the State Health Assessment) that documents the health status of Vermonters at the start of the decade and the population health indicators and goals that will guide the work of public health through 2020. Click here for more information. This indicator is also part of the State Health Improvement Plan (SHIP), a five-year plan that prioritizes broad Healthy Vermonters 2020 goals: reducing prevalence of chronic disease, reducing prevalence of substance abuse and mental illness, and improving childhood immunizations. The SHIP is a subset of HV2020 and details strategies and planned interventions. Click here for more information.

Act 186 was passed by the Vermont Legislature in 2014 to quantify how well State government is working to achieve the population-level outcomes the Legislature sets for Vermont’s quality of life. It will assist the Legislature in determining how best to invest taxpayer dollars. The Vermont Department of Health and the Agency of Human Services report this information annually. Click here for more information.

• • Agency of Education - A collaborator with the Tobacco Program in funding and training youth groups to educate on the dangers of tobacco and how it is promoted, discounted and available to youth in communities across Vermont.
  • 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.
  • Tobacco Community Coalitions - A network of community grantees who work to prevent youth initiation, support quit activity locally and reduce exposure to secondhand smoke while strengthening tobacco norms.
  • Advisors and youth advocates work diligently to educate their communities about the dangers of tobacco and how they are targeted by the industry. The Agency of Education and the Tobacco Program collaborate on funding and training youth throughout the year.
  • Marketing Contractor

Centers for Disease Control and Prevention's (CDC) Best Practices for Comprehensive Tobacco Control Programs gives three specific recommendations for preventing tobacco use among youth: increase tobacco excise taxes and parity among products, packaging, displays, age of purchase and comprehensive indoor and outdoor air restrictions, conduct mass media education campaigns and restrict minors’ access to tobacco products. These recommendations contain strategies that the tobacco program already performs with current funding. One of these strategies is aligning the youth initiation campaign efforts between community coalitions and OVX and VKAT groups and providing training tailored for youth and the communities in which they live. The Program also partners with the Alcohol and Drug Abuse Program to support tobacco cessation via its network of local youth service providers.

The program proposes a multi-pronged approach to increase the coordination and outcomes associated with best practices. In particular, the program will implement and collect data for the following strategies: 

• Conduct digital media on popular social media platforms to increase perception of harm among youth and young adults of tobacco use in particular to drive vaping prevention.
• Implement media to increase awareness and utilization of youth cessation resource, My Life My Quit.
• Educate on use of thousands of flavors by the tobacco industry including the popular flavors menthol, fruits and candies through CounterBalance.org.
• Conduct tobacco retailer audits and disseminate results to partners and grantees for educating locally on the impact tobacco products, sales and illegal youth sales have on community health.
• Educate on the need to reduce the impact of tobacco on youth initiation and tobacco use through raising awareness and generate support for reducing the impact of tobacco advertising in Vermont communities.
• Discuss how tobacco product pricing, flavored products and their placement in addition to store density in communities influence youth initiation and impact cessation rates.
• Continue to work closely and share data with Agency of Education, Attorney General's Office, Department of Liquor and Lottery and substance use prevention and treatment partners to inform collaboration around strategic action.
• Expand the accessibility of youth cessation resources and their promotion including My Life, My Quit.
• Work to eliminate exposure to secondhand smoke among youth and young adults.
• Continue to increase the number and type of tobacco and smoke free environments including college and hospital campuses, parks, beaches and community gathering spots

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.

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