Though Colorado’s overall tobacco use rates aren’t particularly high or low compared to other states, youth tobacco rates continue to be an issue for the state as the youth vaping epidemic continues, according to the American Lung Association’s latest State of Tobacco report.
Tobacco use continues to be the leading cause of preventable death and disease in both Colorado and the U.S., taking about 480,000 lives every year. The pandemic posed unique challenges for tobacco prevention and cessation efforts, as added stress increased tobacco use for many and public health messaging largely focused on COVID-19 prevention efforts.
Data from the Colorado QuitLine indicated about half of people calling were smoking more because of the pandemic. At the same time, about half of people said they were more motivated to quit because of the pandemic. Thomas Ylioja, clinical director of National Jewish Health’s QuitLines, said the data demonstrated the importance of having cessation resources available and keeping the message of quitting front and center for tobacco users.
“There were so many messages in the public consciousness that it was difficult to get through that message about quitting,” Ylioja said, adding that the high-profile election year was another factor making it difficult to get the message out. “Another part was a lot of people talk to their doctor about quitting, and the doctor was telling them to call the QuitLine. … With the lockdowns, people were not going in to see their doctor anymore. They weren’t getting those referrals.”
Tara Dunn, a spokeswoman in the state’s Prevention Services Division, said the state has made a ton of progress reducing tobacco use over the past couple decades. Recently, the state saw its first statistically significant decline since 2014, with a current rate of 13.5% of adults who smoke. In Weld County, nearly one in seven residents uses tobacco products, just slightly above the statewide rate. Cigarette usage has decreased 15% since 2006 in Weld, though chew tobacco usage has increased 2.2%, according to county data. E-cigarette use is also up slightly in the county, especially in adults ages 35-54.
To keep bringing the rates down, officials adapted messaging around quitting.
“The pandemic is kind of threatening this progress,” Dunn said. “We have incorporated COVID messaging into our tobacco messaging.”
That messaging includes acknowledging the research that shows smokers are at an increased risk for severe COVID-19 cases, as well as an increased risk for youth who vape to contract the virus.
Though the American Lung Association awarded Colorado an “A” for access to cessation services like the QuitLine, with comprehensive coverage for all tobacco cessation medications and types of counseling to Medicaid enrollees with minimal barriers, the state earned an “F” when it came to tobacco prevention and control program funding.
The American Lung Association called on the state to protect and increase its funding for tobacco control programs. The association reported Colorado funds its tobacco control programs at just 40.8% of the CDC-recommended level of $52.9 million.
Youth vaping still a serious issue
Though Colorado no longer has the highest rates of youth vaping in the country, data from the most recent statewide survey still shows about one in four Colorado youth vape. The American Lung Association reported youth vaping and tobacco use is largely driven by flavored tobacco products. The 19th annual State of Tobacco report includes a new state grade calling for policies to end the sale of all flavored tobacco products, including menthol cigarettes, flavored e-cigarettes and flavored cigars. Colorado has no laws or regulations regarding flavored tobacco products and earned an “F.”
“While Colorado’s no longer number one in the nation for youth vaping, it’s still really concerning to know that one in four Colorado youth vape,” Dunn said.
Colorado recently launched a new version of its youth-focused tobacco cessation resource with National Jewish Health, My Life, My Quit. The free program makes 24/7 coaching for quitting tobacco products available via text, call or online. Youth can get confidential help by testing “Start My Quit” to 36072 or by going to co.mylifemyquit.org.
Ylioja said they’ve helped more than 500 children in the past year and a half. He added the recent state and federal law changes that made the minimum age to buy tobacco products 21 help prevent youth from getting started with tobacco products.
“Many of those policy changes will help a lot,” he said. “But we also know that youth are able to access tobacco products by going online and those sorts of things.”
Cigarette use among Colorado youth is at an all-time low, Dunn said, with a rate of 5.7% in 2019. That’s down from 8.6% in 2015.
Ylioja said Colorado’s recently passed tax increase on tobacco products should lead to a lot of Coloradans to quit smoking over the next year or so. Revenue from the increased taxes, which include taxing e-cigarettes for the first time, will provide relief to state budget cuts caused by the pandemic for two and a half years. After that, the revenue will be devoted to tobacco education and cessation programs, as well as free early childhood education.
The QuitLine data indicating people have both been smoking more and feeling more motivated to quit due to the pandemic suggests more people need to know about the free resources available to manage the stress associated with quitting.
“The COVID-19 pandemic is stressful, and it’s bringing up a lot of feelings of anxiety and worry,” Dunn said. “Some people are feeling this urgency to quit smoking and improve their health … but they’re concerned about how they’re going to manage that stress and withdrawal.
Dunn said the coaches for the Colorado QuitLine and My Life, My Quit, both of which are free, are trained to help manage withdrawal symptoms. The QuitLine even has free nicotine replacement therapy for those ready to start on their quit journey. The QuitLine can be contacted by calling 1-800-QUIT-NOW (784-8669) or by going to coquitline.org.
“It’s never too late to quit,” Ylioja said. “We know the best thing you can do for your overall health is quit smoking. … Even if you’re not quite ready to quit now, you can reach out and talk to a coach, find the right time to quit for you.”