Updated: February 2023

Author: Cancer Program, Vermont Department of Health

Cancer is a group of more than 100 different disease that often develop gradually and as the result of a complex mix of lifestyle, environmental and genetic factors. The use of tobacco products or regular exposure to secondhand smoke can increase the risk of developing many different cancers, as well as cardiovascular disease, diabetes, and lung disease. Approximately one-third of all cancer deaths in the United States are linked to the use of tobacco products.

Exposure to tobacco increases the risk of developing the following cancers: lung, larynx (voice box), mouth, lips, nose and sinuses, throat, esophagus, bladder, kidney, liver, stomach, pancreas, colon and rectum, cervix, ovary, and acute myeloid leukemia. Lung cancer is the most common tobacco-associated cancer in Vermont and is the leading cause of cancer death.

Vermonters today are more likely to die from a largely preventable disease than an infectious disease. The Health Department’s 3-4-50 initiative is a simple framework to help us grasp the reality of the impact of tobacco use on chronic disease. The initiative promotes the concept that 3 health behaviors (tobacco use, lack of physical activity, and poor diet) contribute to 4 chronic diseases (cancer, cardiovascular disease, lung disease and diabetes) that claim the lives of more than 50 percent of Vermonters.

Cancer is a leading cause of death among Vermonters. Each year, over 3,400 Vermonters are diagnosed with cancer, and more than 1,200 Vermonters die from the disease. Approximately one-third of all cancer deaths in the United States are linked to the use of tobacco products. This measure will help to gauge the success in decreasing the impact of tobacco in Vermont.

Vermont Department of Health Comprehensive Cancer Control Program

Vermont Cancer Registry

Vermonters Taking Action Against Cancer (VTAAC)

The rate of tobacco-associated cancer can be reduced through a comprehensive strategy with efforts to reduce the use of tobacco by Vermonters. Population-wide efforts that change societal environments and norms related to tobacco use - including increases in the unit price of tobacco products, comprehensive smoke-free policies, and hard-hitting media campaigns - increase tobacco cessation by motivating tobacco users to quit and making it easier for them to do so. CDC Best Practices for Comprehensive Tobacco Control Programs gives four specific recommendations for promoting quitting, addressing tobacco use among adults and shifting to tobacco-free social norms

The Vermont Cancer Plan, published by the Vermont Department of Health Comprehensive Cancer Control Program (VT CCC) and the statewide cancer coalition Vermonters Taking Action Against Cancer (VTAAC), provides a strategic roadmap for reducing the burden of cancer in Vermont. The Comprehensive Cancer Control Program, the Tobacco Control Program and VTAAC partners work to coordinate evidence-based priority activities based on the State Cancer Plan and proven strategies to reduce tobacco use among Vermonters. Priority strategies currently underway in Vermont are listed below.

• Educate health care providers on cessation resources, interventions and strategies.
• Coordinate efforts with cancer care providers to increase referrals to 802Quits for cancer patients and survivors.
• Support efforts to increase the number and type of tobacco and smoke free environments including, college and hospital campuses, parks, beaches and community gathering spots.
• Support the decrease in point-of-sale tobacco advertising through policy and education.
• Promote broad media cessation messaging to increase registrants to 802Quits.

In December 2017, the methodology for computing risk factor-associated cancers changed to be consistent with CDC methodology, updated October 2017. The CDC documentation defines cancers associated with certain risk factors, including tobacco, HPV, and obesity. Rates for risk factor-associated cancers published prior to December 2017 should not be compared to rates for risk factor-associated cancers published December 2017 or later. In addition, rates published later than May 2018 should not be compared to rates for risk factor-associated cancers published earlier due to additional methodological changes (excluding non-microscopically confirmed cases). Differences between rates in older versus current publications are likely due to methodological changes rather than changes in the rates or underlying risks for developing risk factor-associated cancers. 

All rates are age adjusted to the 2000 U.S. standard population and exclude basal cell and squamous cell skin cancers. Incidence rates exclude in situ carcinomas except urinary bladder. Incidence data were coded using the International Classification of Disease for Oncology (ICD-O) coding system. Vermont cases include Vermont residents only. Data Source: Vermont Cancer Registry, Vermont Department of Health (1994-2013). A reporting delay by Department of Veterans Affairs (VA) has resulted in incomplete reporting of VA hospital cases in 2011, 2012, and 2013.