Spangler is one of the world's leading experts in tobacco epidemiology and was the keynote speaker for 2004 World Health Organization Tobacco and Community Health Conference in New Delhi, India. He founded the first physician-run tobacco-cessation clinic in North Carolina and was recently awarded $1.6 million grant to develop tobacco cessation curriculum for medical schools across the United States. He has won several prestigious awards including the Association of Teachers of Preventative Medicine Program of the Year Award and the Behavioral Sciences Forum Program of the Year Award. He is currently co-Principal Investigator on a longitudinal study of tobacco use among students at 11 colleges and universities in NC and VA.