Editor’s note: This commentary is by John Hughes, MD, who is professor emeritus of the Department of Psychiatry at the University of Vermont.
It’s great to see that the Vermont Department of Health’s Tobacco Control Program is serving as an effective tool to help people who smoke and vape with quitting. Vermonters are responding — whether it be out of concern over Covid-19’s possible impact on their respiratory systems or because of new resources available to confront teen vaping.
Phone registrations for the program’s 802Quits tobacco cessation services in March 2020 were up 41% compared to March 2019, and web registrations were up by a whopping 167% due, in part, to a spring paid digital media campaign to support parents who are helping their kids end addiction to vapes.
As a former member (2000-2008) and chair (2002-2004) of Vermont’s Tobacco Evaluation and Review Board, I’m not surprised by the progress in ending tobacco dependence in our state. We have repeatedly seen just how effective the Tobacco Control Program is at offering customized support, including counseling paired with nicotine replacement therapy, which increases cessation success by up to four times over trying to quit cold turkey. As a result, the adult smoking rate dropped 19% between 2016 and 2018 and Campaign for Tobacco Free Kids ranks Vermont’s adult smoking rate as 10th lowest in the nation.
Between March and April, visits to 802Quits.org rose by 971 visitors and web registrants increased by 24%. An increasing number of registrants include those targeted by the tobacco industry and at higher risk for initiation, including American Indians and young adults.
Despite sharp increases in youth use of e-cigarettes beginning in 2017, traditional cessation services were tailored for adult users. Quit lines, including Vermont’s, have been available to ages 13 and older but the program is now working to add a youth component designed to resonate with a younger audience and increase the ability to connect by phone, text, online and live chat. This is an important resource in the wake of escalating use of e-cigarettes by youth, including 26% of Vermont high school students reporting current use in 2019.
Prevention of initiation and use of tobacco products, which includes e-cigarettes and vape products, is core to the Tobacco Control Program’s mission. While the industry’s tactics, including marketing and flavors, enticed many Vermont youth to start using vapes, the program has been working incessantly to increase perception of harm. Along with grantees and partners, the Tobacco Control Program has focused on education, counter marketing and promotion of the Unhyped youth anti-vaping campaign.
In 2012, the Tobacco Control Program launched a collaboration with the Department of Vermont Health Access to make Medicaid benefits for smoking cessation more comprehensive and accessible. The result: Smoking declined from 36% to 29% among Medicaid-insured adults between 2013 and 2018. This includes a 2% decline in smoking between 2017 and 2018. While that may not sound like a lot, it has a huge impact when translated into health care savings: $12.2 million. Early evaluation of the program by independent evaluator Research Triangle found that between 2001-2014, $73 million invested in the program helped net an estimated $1.43 billion savings in overall smoking-related health care costs in Vermont, which includes $586 million in Medicaid costs.
State programs that are quietly successful can be overlooked and vulnerable to reductions in funding. But the data clearly shows that any reductions to the program over the long run will dramatically increase expenditures.
The Vermont Tobacco Control Program is a true “win/win.” It both saves Vermont lives and saves the state and taxpayers money.
