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What it leaves out is that 86 cents of every Tobacco Fund dollar goes to Medicaid, that the program specifically designed to help Vermonters quit smoking runs on roughly 31 cents of tobacco money per dollar and operates at 44 percent of the CDCs recommended funding level, and that Vermont has never built the kind of public accountability structure around tobacco settlement spending that it built twenty-five years later for the opioid settlement

This provides an additional indirect mechanism linking smoking to worsening acne beyond the direct skin effects What the research on smoking and acne actually shows A key piece of research establishing the smoking-acne connection is a 2009 study by Capitanio et al., published in the Journal of Investigative Dermatology , which examined acne patterns in a large cohort of adults and found a specific association between smoking and non-inflammatory acne characterised by comedones and congestion rather than the inflamed papules and pustules of classic inflammatory acne

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