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Dr. Stephen Leffler & the University of Vermont Medical Center Support a Tax to Reduce Obesity and Health Care Costs

The University of Vermont Medical Center has been outstanding in its support of a two cent per ounce excise tax on sugary drinks to reduce obesity in Vermont. Stephen Leffler, the Chief Medical Officer for the hospital, has been a tireless advocate testifying before a legislative committee, speaking at a press conference launching the campaign and recently posting the following on the Medical Center's blog.

Why We Support a Tax on Sugary Beverages

Recently, I had the opportunity to travel to Montpelier and advocate for a tax on sugary drinks. You might wonder why a physician would get involved in a tax debate? It’s simple. It’s because sugary drinks are a significant health concern for Vermonters.

Obesity and diabetes are major health issues for Vermonters and our country. Sugary drinks are linked to both conditions. The future of health care is partnering with and engaging our patients to keep them as healthy as possible. We know that the long-term health of our patients is influenced more by their actions and choices during daily life, versus what happens when they’re in our exam rooms. Patients who make good choices in terms of smoking, exercise and diet will live longer and healthier lives and consume less health care resources. That is how you drive down health care costs.

Public policies can be powerful tools to aide in these efforts. Policies, such as taxes, can help our patients make better, healthier choices. Cigarette taxes have proven this. As the cigarette tax has increased, smoking rates have dropped. Would any of us consider turning the clock back on that and go back to the days when nearly 40 percent of us were smoking $2 packs of cigarettes? If a 1-liter soda costs more than a pint of milk or water, more people will make the healthier choice. Why does that matter? Because sugary drinks are a major factor in obesity. Researchers estimate that sugar-added drinks account for at least one-fifth of the weight gained by the U.S. population between 1977 and 2007.

Consumption of sugary drinks is the single largest category of caloric intake for U.S. children, surpassing milk in the late 1990s. Think about that for a second. Sugary drinks account for more calories than fruits, vegetables, dairy products and healthy protein sources. Increasing the cost of sodas and energy drinks will help people make better choices. They will likely consume healthier, cheaper alternatives.

To be clear, there is nothing wrong with an occasional soda. It should be a treat. Like having an ice cream cone. Today, many people do not think of a soda like a treat. Most people trying to eat a healthy diet would not have six ice cream cones a day but may not think twice about drinking a six pack of soda. That could be more than 1,000 empty calories with no nutritional benefits.

I grew up in a small town in Vermont and my parents owned a general store. I spent many hours of my life stocking coolers with sodas, milk, water and so on. I witnessed Vermonters making choices about what to buy every day. They were smart with their money. Making sugary drinks more expensive will help them be even smarter with their money and their health.

What’s more, the money raised from a sugary beverages tax can be used to help teach Vermonters and their children how to eat healthier, and actually make more nutritious foods more easily available. For example, we could direct funds to expand the impact of food access programs like Vermont Farm to Family, NOFA Vermont’s Farm Share program, Green Mountain Farm to School, and Vermont FEED – not to mention new programs. Revenue could also be used to offset the increased costs incurred from obesity. I firmly believe this tax is the right thing for our patients and our state.

Stephen M. Leffler, MD, FACEP, is the Chief Medical Officer at the UVM Medical Center, former Medical Director of the Emergency Department, and has been a practicing physician for 20 years. He is also a Professor at the University of Vermont College of Medicine. He grew up in Brandon, Vermont.


Block G. Foods contributing to energy intake in the US: Data from NHANES III and NHANES 1999–2000. J Food Comp Anal 17 (2004): 439-47.

Woodward-Lopez*, Janice Kao and Lorrene Ritchie, To what extent have sweetened beverages contributed
to the obesity epidemic? Public Health Nutrition p. 4 (2010)


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Getting Some Traction on the Sugary Drink Tax!

Legislators left Montpelier for their March break with interest hanging on the sugary drink tax. The House Health Care Committee took testimony on the tax as a possible source of revenue for health care reform measures and will likely vote on the tax when they return on March 10th. Read more here. 

The House Ways and Means Committee will also focus on the tax with a hearing slated for March 11th.  Lawmakers are looking at closing a $112 million budget gap and with a list of $29 million in potential budget cuts presented recently, some lawmakers are also interested in new sources of revenue.  

The American Heart Association and the Alliance for a Healthier Vermont want to implement a 2 cent per ounce excise tax on sugary drinks to reduce consumption of sugary drinks and use a portion of the revenue for obesity prevention efforts and greater access to health care for underserved Vermonters. 

A new poll released by VTDigger shows Vermonters agree. 57% said they would support a tax on sugary drinks to fund health care for low income Vermonters. Editors from newspapers across Vermont also agree it makes sense. The St Albans Messenger, Addison Independent, Rutland Herald, Times Argus, Brattleboro Reformer and County Courier have all written editorials urging lawmakers to pass the tax this session. Check out the following editorial! 

With both obesity rates and health care costs climbing, the sugary drink tax should be a priority for Vermont lawmakers. 

The Robert Wood Johnson Foundation and the Trust for America’s Health notes in its State of Obesity report for Vermont that Vermont’s current 38,031 cases of heart disease could sky-rocket to 190,617 by 2030 if we continue on our current trend. A two cent tax on sugary drinks and a commitment to prevention makes more sense to us. 

Urge Vermont lawmakers to support prevention efforts such as this to reduce chronic diseases in Vermont. Click on the following to take action: 

And help us spread the word by “liking” the Alliance for a Healthier Vermont Facebook page and sharing the benefits about a sugary drink tax on your social media today!

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Cutting Funding for Tobacco Prevention is a Step Backwards

Despite the historic successes of Vermont’s tobacco control program, tobacco use is still the number one preventable cause of death and disease. While we’ve made great headway, there is more work that needs to be done and the program is at risk. 

The Governor’s proposed budget would cut nearly $245,000 this coming year, reducing funds to the health department and eliminating funding for the independent Tobacco Evaluation and Review Board. 

This cut in prevention funding will only move Vermont backwards in the state’s efforts to control skyrocketing healthcare costs. Vermont currently spends $348 million each year on tobacco-attributable health care expenses.

Tobacco use still claims the lives of 1,000 Vermonters annually.  400 children become new daily smokers each year and 10,000 Vermont children currently alive today will die prematurely from smoking. We have populations where smoking rates are high – over 20% of Vermont’s college-age youth smoke and smoking rates for those with low incomes or serious mental illness are at or above 30%.

Help us urge Vermont lawmakers and the Governor to maintain funding for the tobacco program to reduce these numbers and support a significant increase in the tobacco tax – proven measures that will reduce smoking in Vermont. Click the link below to take action today!



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Campaign to Pass a Sugary Drink Tax Picking Up Steam! You Can Help!

Campaign Launched at Press Conference! The American Heart Association along with the Alliance for a Healthier Vermont officially launched our effort to pass a 2 cent per ounce excise tax on sugary drinks at a Statehouse press conference on January 20th. The result? Legislators, media and Vermonters are talking about the effort!

At the press conference, Alliance for a Healthier Vermont Campaign Director Anthony Iarrapino said a portion of the $34 million in revenue from the tax could be used to fund affordable health care programs, help subsidize the purchase of healthy foods for low-income Vermonters, and increase funding to create a more comprehensive state obesity prevention program.

 “Education alone is not enough to improve health and reduce health care costs. A two-cent-per-ounce excise tax modeled on the successful tobacco tax can level the playing field for healthier beverage choices like milk and water, while also raising substantial new revenue for health care, food access, and other pressing needs,” he said.

 American Heart Association national nutrition committee member Rachel Johnson added, “Food is essential to life, but sugary drinks are not.  Sugar-loaded drinks contribute only empty, nutrient void calories to the diet and increase the risk of many chronic diseases including heart disease, diabetes and some cancers.”

 More than 30 Vermont organizations are now part of the Alliance in support of the sugary drink tax, including the state’s hospitals and the largest low income advocacy group.

 We're in the news and editors are supporting the tax! We’ve been in the news quite a bit as we continue to talk up the effort with lawmakers and media, and we’ve received editorials from the Rutland Herald, Addison Independent and St. Albans Messenger in support of the tax. Check out some of the stories and share on social media:

 You can help! If you haven’t taken action yet to support our efforts, there are many ways you can help. We can't do it without you!

  • Go to the Alliance web site and sign our resolution.
  • Urge your family and friends to get involved. Just text HEALTHYVT to 5-2-8-8-6. It’s easy!
  • Take a sugar-free selfie of you or your family drinking a healthy drink and send it to us to post and the American Heart Association and Alliance Facebook pages. Email and post on your own page as well!


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Tobacco and Obesity - A $550 Million Dollar Price Tag for Vermont

Though prevention is a lot less expensive than the treatment of chronic diseases, Vermont legislators are now considering a budget proposal from the Governor that would cut $500,000 from tobacco and obesity prevention initiatives in Vermont at the same time the State is spending $550,000,000 on health care costs to treat chronic diseases like heart disease, stroke, cancer and diabetes, that are caused by smoking and obesity.

Annually, Vermont spends $348 million treating tobacco-rated illnesses and another $202 million treating obesity-related diseases. We can’t expect these numbers to go down by themselves. Additional spending on prevention could help lower health care costs by reducing chronic diseases in our state.

However, the Governor’s proposed budget proposal includes more than $200,000 in cuts to Vermont’s Tobacco Control Program (including evaluation funding that ensures effective spending of state dollars) and eliminates the $300,000 currently going towards obesity prevention efforts in Vermont.

 Tobacco and obesity are definitely having an impact on Vermonters' health and their wallets.

While Vermont has successfully cut the youth smoking rate in half, tobacco use claims the lives of 1,000 Vermonters annually, 400 children become new daily smokers each year, 20.4% of Vermont's college-age youth smoke and smoking rates of low income Vermonters are 30%. the price tag for treating tobacco-related illnesses in Vermont is $348 million annually.

Obesity as well is taking its toll with over 60% of Vermont adults and 29% of Vermont children overweight or obese. The health care costs related to adult obesity related illnesses in Vermont is $202 million and this does not take into consideration the health impact of obesity on Vermont's children.

Click the following link to tell your legislators to oppose these cuts and support prevention funding to lower heart disease and stroke costs. Significantly raising the price of tobacco and sugary drinks is a good place to start.


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Dr. Niels Giddins - Fighting Obesity for the Health of Vermont Kids

This generation of kids is the first to have a shorter life expectancy than their parents. Currently, 29% of Vermont's children are overweight or obese.

Dr. Niels Giddins is a pediatric cardiologist at the University of Vermont Medical Center and a board member for the American Heart Association who wants to change that.  He has joined us in the fight for a two cent per ounce excise tax on sugary drinks in an effort to reduce obesity in Vermont.

You'll hear his voice on Vermont airwaves and see him in local papers. And, he spoke to legislators at the American Heart Association's legislative reception this month.

Here's a portion of his statement from that event:

Simply put, most Vermont adults are overweight or obese, and our youth are catching up fast.  The adverse effects on their health are undeniable. Not only are the lengths and quality of their lives compromised, our health system is compromised due to the increasing amounts of expensive care needed to treat the various problems that result — such as high blood pressure and diabetes.

We counsel our patients that the biggest factor in weight control is the energy or calories taken IN.  What we eat and drink. Obviously the energy or calories that we expend can help balance things out, but the heart of the problem if you will is that when you take in more than is expended your weight goes up.  And if the calories are just plain carbs, with no other nutritional value, the imbalance is just that much worse.

It is with this simple equation that this tax can make the most impact.  Anything to reduce the empty calories consumed by Vermonters will make a difference.  Healthy alternatives abound and become more appealing if relatively cheaper.  This includes milk that supports our own dairy industry, and juices that supply needed fruit and vegetable-derived nutrients.  Let's not forget just plain water - one of the natural resources that many in this state have worked diligently to protect.  Our municipalities provide some of highest quality drinking water anywhere– freely available right out of the tap.

Make no mistake, this is not a ban on sugary drinks.  They're still going to be available, but in return for their negative impact on our health, this tax can provide much needed funds for our stressed healthcare system.

Finally, a word to business owners that perhaps understandably have had concerns about the impact of this tax on their livelihood.  I'd like to think that certain pharmacies that have stopped selling tobacco products have done so NOT to lose money.  The right decision helps everyone.  Healthy sells as well.  

Let’s do this.  

Learn more about the impacts of sugary drinks on obesity and our efforts to pass a tax on sugary drinks at our coalition site:

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Tobacco Tax is a Win Win

Vermont is currently spending $348 million each year to treat smoking-related illness, $72 million of which are taxpayer-funded Medicaid expenditures.  We need to do more to reduce tobacco use and this financial burden.

Increasing Vermont’s cigarette tax by $1.25 is part of the answer.  It will prevent 2,400 kids from becoming smokers and spur 2,700 adult smokers to quit.  This translates into a savings of $96 million in long-term health care costs. 

At a time when the Vermont legislature is looking for more and more ways to reduce the deficit, this is a win-win that improves the health of Vermonters while improving the state’s fiscal outlook.

Urge Vermont legislators to make tobacco prevention a priority. Take action now at:

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An Ounce of Prevention is Worth a Pound of Cure

Theses famous words from Benjamin Franklin can ring true in a whole new way for Vermonters this year. Obesity has become an epidemic, and the health of our country is worse than it’s been before. But in Vermont, we can do something about it. 

A two-cent-per-ounce sugary beverage tax will set us in motion to reverse obesity, especially in children, and help those less fortunate in our state live more healthfully. Every ounce a Vermonter doesn’t drink makes that individual healthier, and every ounce they do drink helps supports programs that make all of Vermont healthier.

Given that consumption of sugary drinks in the U.S. has increased 500 percent over the last five decades and one-fifth of the weight gained by American in the last 30 years has been from sugary drinks, a two cent per ounce excise tax on sugary drinks may be just what we need to start taking those pounds off.

An ounce of prevention is worth a pound of cure. It’s time for Vermont to end its addiction to sugar-loaded drinks one ounce at a time. It’s time for Vermont to help our children lead healthier lives and provide them with better health care options. It’s time to move forward with the sugary beverage tax.

Go to to learn more and sign our resolution.

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Northeastern Vermont Regional Hospital, No Sugar Added!

Congratulations to Laural Ruggles and the Fit and Healthy Coalition at Northeastern Vermont Regional Hospital. They’re taking obesity seriously and have launched a “No Sugar Added” campaign.

The social marketing campaign helps educate the community about the harms of sugar-loaded drinks and benefits of drinking water.

When NVRH conducted a Community Health Needs Assessment in 2012, obesity was identified as one of the top three health priorities for the hospital service area.

Although not the only factor, research has confirmed that sugary drinks are a significant contributor to the obesity problem. So, after conducting focus groups and research on the issue, NVRH’s team decided to tackle the problem head-on with their No Sugar Added campaign targeting dads and kids 13 and under.

You can check out their great videos by clicking on the following links and please share them on your social media!

Dad 1

Dad 2

Dad 3

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Do You Live in a HEART Safe Community?

Its Sudden Cardiac Arrest Awareness Month. Do you know if your community is HEART safe?

The HEART Safe program recognizes communities that meet specific criteria that help increase the potential for saving the lives of individuals who have sudden cardiac arrest through the use of CPR and increased public access to defibrillation.

 Congratulations to Stowe, Bennington and St. Johnsbury for already achieving this distinction.  Designation as a HEART Safe Community represents a coordinated effort by emergency medical services, fire departments, and police departments, as well as other various town departments, schools, and businesses that have committed to saving lives.

Talk to your local rescue and town officials and you can email the Vermont Office of Emergency Medical Services at for more information. By becoming a HEART Safe Community, your town officials, and citizens will be recognized for taking the time, and making the effort to become an invaluable link in the chain of survival.

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