August 2023

Tobacco associated disease, mortality and burden is not evenly distributed across Vermont’s population. In 2021, BRFSS data showed 30% of Vermonters who report having a physical or cognitive disability report smoking every or some days which is nearly double the state average of 16% among Vermont adults. The Vermont Department of Health began collecting and calculating data on this measure in 2017, and there appears to be no significant changes in this trend.

Tobacco use is the number one preventable cause of death. In Vermont, smoking costs approximately $404 million in medical expenses and results in about 1,000 smoking-related deaths each year. The 2021 Behavioral Risk Factor Surveillance Survey (BRFSS) Report found that 16% of adults in Vermont smoke every or some days.

This indicator is part of the State Health Improvement Plan for 2019-2023. The Plan documents the health status of Vermonters, the disparities between different populations, and goals that will guide public health work through 2023. The State Health Improvement Plan has an emphasis on populations that experience health disparities.

National Jewish Health (NJH)- The Tobacco Program's contractor provides the phone, web, and text messaging support for those trying to quit tobacco known as 802Quits. The services on the phone are offered in over 200 languages. Services on the web are offered in English and Spanish. Incentives for completing counseling sessions (referred to as health coaching sessions) are available for specific populations. 

Blueprint for Health- The Blueprint for Health designs community-led strategies for improving health and well-being. This work includes designing and improving health care delivery. The Blueprint for Health collaborates with the Tobacco Program offering the Vermont Quit Partner program the in-person branch of 802Quits.

Department of Disabilities, Aging and Independent Living – The Department of Disabilities, Aging and Independent Living works to improve the lives of Vermonters through providing training for providers and caregivers, programs for persons with physical disabilities as well as older Vermonters.

Green Mountain Self-Advocates- Green Mountain Self-Advocates is a Vermont organization of people with developmental disabilities building self-advocacy skills and educating the public about strengths, rights, and needs of the community.

The Tobacco Control Program (TCP) deploys a number of best-practices for alleviating health disparities. 

• Assure that questions regarding disabilities are included in programmatic surveys in order to monitor the disparity and reach of programs into these communities and share the results
• Protect against second hand smoke exposure through encouraging smoke-free events and working to implement smoke-free multiunit housing across Vermont
• Offer quit support that is inclusive and accessible for people with cognitive and physical disabilities
• Ensure media campaigns reach and impact populations with disabilities and ensure messaging is inclusive
• Educate on raising tobacco taxes to fund programs for people with disabilities
• Evaluate the impact and efficacy of current programs used by people with disabilities
• Diversify the tobacco control movement through engaging community members with disabilities to gain knowledge and information on how to better serve the population

Everybody, including people with disabilities and others in groups with higher tobacco burden, needs to be supported in not starting to smoke and quitting if they do smoke.  These strategies are part of CDC’s Comprehensive Best Practices for Tobacco Control Programs. Combined with the Task Force recommendations in The Community Guide, prevention and treatment should be promoted, accessible and effective for everyone in rural areas, towns and cities across Vermont.

The TCP uses multiple recognized strategies to lower the prevalence of smoking among people with disabilities.

• The TCP includes questions about disabilities on its 802Quits quitline and quit online intake and on major surveys.
• The TCP has worked to disseminate curriculum appropriate for people with cognitive disabilities to the in-person program coaches. The 802Quits in-person program is also using technical support to evaluate the accessibility of their materials.
• The program’s phone support contractor, National Jewish Health, trains coaches regarding working with callers with physical disabilities and will be developing a training for those experiencing cognitive disabilities. National Jewish Health also ensures that materials are at a fourth-grade reading level.

Current smoking is defined as having smoked at least 100 cigarettes in a lifetime and now smokes every day or some days. Two years of data are combined for this measure (most recent year is noted in graph) and results are weighted to represent the Vermont adult population (18 or older).

Vermont tracks risk behaviors and chronic disease using a telephone survey of adults called the Behavioral Risk Factor Surveillance Survey (BRFSS). Vermont participates in the BRFSS with the Centers for Disease Control and Prevention (http://www.cdc.gov/brfss). Every year the Vermont Department of Health fields questions related to smoking and tobacco product use status, present and past use. The CDC recommends monitoring smoking and tobacco use and enacting policies and interventions to prevent use among all ages and populations. adults with any disability definition includes anyone who reports serious difficulty seeing, hearing, walking or climbing stairs, dressing or bathing, concentrating or making decisions, or who, because of a physical, mental, or emotional condition has difficulty doing errands alone. For additional information on the questions used to collect these data please refer to the Health of Vermonters Living with Disabilities.

In order to remain consistent with the methods of comparison at a national level, this measure is age-adjusted. In other words, the estimates were adjusted based on the proportional age breakdowns of the U.S. population in 2000. For more detailed information on age adjustment visit http://www.cdc.gov/nchs/data/statnt/statnt20.pdf.