Reduce the number of Vermonters who smoke

# of statewide laws on smoke-free indoor air to prohibit smoking in public places

132021

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Story Behind the Curve

Last updated: September 2022                                                                       Author: Tobacco Control Program

Healthy People 2020 lists 17 statewide tobacco policy objectives (TU13). One of the policies, smoke-free casinos, does not apply in Vermont.

In 2014, 8 statewide laws were in effect including bans in commercial daycare centers and in correctional facilities. By 2018 Vermont had implemented 11 of the 16 laws (excluding smoke-free casinos). Through the work of state college and health system leadership, the tobacco program and its tobacco coalitions, Office of Local Health and other community partners, by end of 2019 Vermont's institutions of higher learning and hospitals had accomplished becoming smoke-free.  

In 2022 there are 3 remaining statewide policies Vermont has not yet implemented: 100% smoke-free: (1) home-based daycare facilities, (2) non HUD multi-unit housing, and (3) public entryways/exits. The tobacco program is actively pursuing several interventions to address these gaps. One is offering a template that towns/municipalities can use to make private and public rental housing smokefree. Another project is working with landlords and property managers on reinforcing their smokefree propery policies or making their property smokefree. The program has a Smokefree Multiunit Housing Toolkit available on its website. Thirdly, the tobacco program is educating around the protections of 25 foot barriers. In 2014 Vermont passed legislation requiring 25 foot smoke free barriers around state-owned buildings. Doing the same for commercial buildings would offer similar protections for employees, guests and toursists.

Exposure to secondhand smoke occurring in multi-unit housing remains the tobacco program's highest source of complaint calls.  The program's tobacco community grantees are funded to work closely with partners, stakeholders and local experts at Offices of Local Health to provide technical assistance and free signage that can help landlords and property managers with creating a smoke-free building or property. While we have numerous local success stories for smoke and tobacco free campuses around daycares and some municipal and business entryways/exits, CDC encourages state-level policy to ensure consistency and sustainability of protection.

In 1993, Vermont passed the Clean Indoor Air Act, banning the use of combustible tobacco products within indoor areas of most public places. This law initially included an exemption for restaurants and bars that received more than 50% of revenue from alcohol sales and entertainment, known as the “Cabaret exemption.” In 1995 Vermont public schools became smoke-free indoors. With Vermont establishing a Tobacco Control Program in 2001 with Master Settlement Agreement dollars, it was able to work more aggressively on tobacco control and prevention. In 2005, the Cabaret exemption was removed, requiring all bars and restaurants to be 100% smoke-free. Historically the Tobacco Control Program (TCP) worked closely with partners including the Coalition for a Tobacco Free Vermont and the former Vermont Tobacco Evaluation and Review Board (VTERB) to reduce secondhand smoke exposure through increasing the number of statewide smoke-free air laws. For example, one initiative, the youth-led “Free My Ride” campaign, educated on the dangers of smoking in a vehicle with children present, which culminated in the legislature passing restrictions on smoking in cars with children under 8. Another initiative, the CounterBalance campaign, seeks to increase understanding of flavored tobacco products and reducing their impact on youth initiation and use of tobacco.

Vermont has made significant progress in passing policies that protect from hazardous secondhand smoke, reduce youth access and contribute to people quitting. In 2012 VTERB and advocates worked on establishing price parity among cigarettes and other tobacco products which helps to prevent consumers switching to another harmful product when the price of cigarettes increases. In 2014, Act 135 passed which established a number of protections including restrictions of smoking in cars with children under 8 and in hotels/motels, creation of a minimum of 25 feet smoke-free boundary around state-owned buildings, and 24/7 tobacco-free restrictions for schools and daycares. In 2015 state grant requirements included tobacco-free grounds and integration of tobacco into treatment for substance abuse treatment centers and efforts continue to create healthy environments for residential mental health centers. In 2016 Act 108 restricted the use of e-cigarettes wherever lit tobacco products are banned.

See below for a historical look at national and Vermont policy passage including tax increases and the decline in the state’s smoking prevalence. The most recent increase was in 2015, when the rate increased to $3.08 per pack of 20. Tax increases are evidence based to decrease tobacco use, especially for price-sensitive youth.

Note: In 2011, the Centers for Disease Control and Prevention implemented changes to its survey methodology for more accurate representation of the adult population. The graphs may appear continuous but data before 2011 should not be directly compared to that after 2011. Fortunately, this change more accurately reflects the burden of smoking among more disparate populations, especially the low-income.

Partners

Coalition for Tobacco-free Vermont: a network of health voluntary organizations (Cancer, Heart, Lung) and community coalitions that work to advance policies to protect Vermonters from the impact of tobacco.

Tobacco Community Grantees: 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.

Vermont Kids Against Tobacco (VKAT) and Our Voices Exposed (OVX) 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.

 

What Works

According to CDC Best Practices for Comprehensive Tobacco Control Programs, successful public health practice involves coordinated community and state resources. The Task Force on Community Preventive Services discusses the effectiveness of population-wide approaches including smoking cessation, preventing tobacco initiation, and eliminating exposure. Among the most effective are policy interventions including tax increases and parity among products, packaging, displays, age of purchase and comprehensive indoor and outdoor air restrictions. For example, smoke-free laws are an evidence-based way to protect the public from secondhand smoke and reduce smoking prevalence. The Vermont Department of Health turns the curve by coordinating TCP efforts with those of tobacco-control advocates, providing ongoing support and technical assistance to community and youth coalitions on educating the public on the dangers of secondhand smoke exposure, and distributing background information and research around secondhand smoke and smoke-free laws.

Strategy

The program will continue to educate key stakeholders and the public on the importance of reducing secondhand smoke exposure.The program will:

  • Disseminate research and resources on the dangers of secondhand smoke exposure and retail advertising including the higher number of stores and product promotion in low-income areas.
  • Disseminate research and resources on secondhand exposure to aerosol from e-cigarettes or other electronic nicotine delivery systems (ENDS).
  • Identify populations disparately affected by secondhand smoke exposure, including racial and ethnic minorities and the mental health and substance abuse populations, and advance policies to reduce exposure and tobacco use burden.
  • Continue policies, partnerships and intervention activities at local and state level that lead to social norm and behavior change. The Health Impact Pyramid is a framework that demonstrates that the greatest improvements come from policy change that create environments of health and healthy choices.

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.

Why Is This Important?

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.

This indicator 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.

Notes on Methodology

Data is updated as it becomes available and timing may vary by data source. For more information about this indicator, view Healthy People 2020 TU-13: Establish laws in States, District of Columbia, Territories, and Tribes on smoke-free indoor air that prohibit smoking in public places and worksites

Scorecard Result Container Indicator Measure Action Actual Value Target Value Tag S R I P PM A m/d/yy m/d/yyyy