Home | Contact Us | Press Room | Site Overview | Help | Login | Register

Tobacco Cessation: State and Federal Efforts to Help

Updated: September 2008

Many states sponsor a state-wide tobacco cessation program to assist residents that would like to quit smoking or using tobacco. Such programs have been created in response to health problems as well as the related state costs in caring for people, including state employees, with tobacco related diseases and conditions. States are working to reduce their expenditures and improve the health of all of their employees and residents.

The following links and resources may be helpful to legislators or legislative staff researching this issue.*

NCSL resources
(As seen in State Legislatures magazine, September, 2008)

Tobacco use is the leading preventable cause of disease, disability and death in the United States, according to the Centers of Disease Control and Prevention (CDC). In a growing number of states, both Medicaid and state employee health programs have led the way toward reducing smoking and chewing tobacco by employees, enrollees and their families.

Some plans offer tobacco cessation programs within existing managed care insurance plans, while others have "carve-out" or stand-alone services. Cessation programs often include access to over-the-counter and prescription treatments at reduced or no cost. Some programs offer counseling services and support groups. The CDC has developed recommended guidelines for such programs.

In state employee programs, at least six states provide an incentive to kick the habit by charging a higher premium to smokers.

All states and a few territories offer the general public resources to quit, which can be used by state employees or Medicaid enrollees who do not have their own specific health insurance or tobacco cessation programs.

Map of state employee tobacco cessation programs:

Table of state Medicaid cessation programs:

State/Territory

Covers some over-the-counter products

Covers some Rx products

Covers therapy, counseling or social support

Alabama *

N

N

N

Alaska *

Y

Y

Y

Arizona*

N

N

Y

Arkansas *

Y

Y

Y

California

Y

Y

Y

Colorado *

Y

N

Y

Connecticut

N

N

N

Delaware

Y

Y

N

District of Columbia *

Y

Y

N

Florida *

Y

Y

N

Georgia *

N

N

N

Hawaii *

Y

Y

N

Idaho

N

N

N

Illinois

Y

Y

N

Indiana *

Y

Y

Y

Iowa*

N

N

Y

Kansas

N

Y

N

Kentucky*

N

N

Y

State/Territory Covers some over-the-counter products Covers some Rx products
Covers therapy, counseling or social support

Louisiana

Y

Y

N

Maine *

Y

N

Y

Maryland *

Y

Y

Y

Massachusetts *

Y

Y

Y

Michigan *

Y

Y

N

Minnesota *

Y

Y

Y

Mississippi

Y

Y

Y

Missouri *

N

N

N

Montana *

Y

Y

N

Nebraska

N

N

N

Nevada *

Y

Y

N

New Hampshire *

Y

Y

Y

New Jersey

N

Y

N

New Mexico

Y

Y

Y

New York *

Y

Y

Y

North Carolina

Y

Y

N

North Dakota *

Y

Y

Y

Ohio *

Y

Y

N

Oklahoma *

Y

Y

Y

State/Territory Covers some over-the-counter products Covers some Rx products Covers therapy, counseling or social support

Oregon *

Y

Y

Y

Pennsylvania

Y

Y

Y

Puerto Rico*

N

N

N

Rhode Island *

Y

N

Y

South Carolina

Y

Y

Y

South Dakota *

N

Y

N

Tennessee *

N

N

N

Texas *

Y

Y

N

Utah *

Y

Y

Y

Vermont *

Y

Y

N

Virginia

Y

Y

Y

Washington*

N

Y

Y

West Virginia *

Y

Y

Y

Wisconsin *

Y

Y

Y

Wyoming *
N

N

N

Source: Centers for Disease Control and Prevention, 2006.

* Statewide public program available, coverage may vary from other programs. Arizona, Iowa, Kentucky and Washington, offer smoking cessation coverage exclusively for pregnant women.

The Centers for Disease Control & Prevention (CDC) has published many resources on tobacco cessation, including a set of clinical practice guidelines. Click here for more information.

Links to state-wide tobacco cessation programs:

Alabama: www.adph.org/tobacco Alaska: Arizona: www.ashline.org Arkansas: www.stampoutsmoking.com Colorado: www.tobaccofreecolorado.com

Florida: www.flquitline.com Georgia: www.livehealthygeorgia.org Hawaii: www.callitquitshawaii.org Indiana: www.indianaquitline.net Iowa: www.quitlineiowa.com

Kentucky: www.gethealthy.ky.gov Maine: www.tobaccofreemaine.org Maryland: www.smokingstopshere.com Massachusetts: www.trytostop.org and www.quitworks.org
Michigan: www.tobaccofreemichigan.org

Minnesota: www.quitplan.com Missouri: www.dhss.mo.gov/SmokingAndTobacco/ Montana: http://tobaccofree.mt.gov/
Nevada: www.livingtobaccofree.com
New Hampshire: www.trytostop.org

New Mexico: www.quitnownm.com
New York: www.nysmokefree.com North Dakota: www.ndhealth.gov/tobacco/quitline.htm Ohio: www.ohioquits.com
Oklahoma: 1-866-PITCH-EM
http://www.ok.gov/tset/Programs/Tobacco_Use_Prevention_and_Cessation/Oklahoma_Tobacco_Helpline/

Oregon: http://www.oregonquitline.org/ Pennsylvania: 1-800-784-8669
http://www.dsf.health.state.pa.us/health/cwp/browse.asp?A=174&C=35485 Rhode Island: http://www.trytostop.orgcom South Dakota: http://www.healthysd.gov/QuitTobacco.html Tennessee: http://health.state.tn.us/tobaccoquitline.htm

Texas: http://www.dshs.state.tx.us/tobacco/quityes.shtm Utah: http://www.tobaccofreeutah.org/quitline.htm Vermont: http://vt.quitnet.com/qn_main.jtml Washington: www.quitline.com West Virginia: www.wvquitline.com

Wisconsin: www.wiquitline.org Wyoming: http://wellbeingofwyoming.org/quit.htm

District of Columbia: www.smokefree.gov

Archived NCSL webpage on Tobacco Use Cessation: The Effectiveness of Quit Lines.

Additional articles that may be available for a fee, registration, or membership basis:

WY: Report: State loses millions due to tobacco use , By Allison Rupp, Casper Star-Tribune
Tobacco use costs Wyoming hundreds of millions of dollars each year in lost productivity and health care, according to a report released by the state on Thursday. Read More

State tobacco control pays off, advocate says San Francisco Chronicle, 2008-08-26
By Matthew B. Stannard, Chronicle Staff Writer
A newly published study by researchers at UCSF estimates that the California Tobacco Control Program has saved some $86 billion in personal health care costs - a 50-fold return on investment. The exact amount saved is tricky to pin down - the study, published online in the peer-reviewed journal PLoS Medicine, had a confidence interval of $28 billion to $151 billion, meaning the researchers determined a 95 percent probability that the actual savings lies between those two figures. The estimates are calculated in constant 2004 dollars.
Stanton Glantz, senior author of the paper and director of the UCSF Center for Tobacco Control Research and Education, said the width of the confidence interval reflects cutting-edge statistical analysis and the inherently variable nature of human health research. The important point, he said, is how much the analysis shows the state reaped from the $1.8 billion it invested in the program in its first 15 years."Even if you took the lower end of it, of $28 billion, it's still 15 times what the program cost," says the article. 8/27/08

Tobacco Cessation Benefit Provides Major Return on Investment: In its first six months, a new insurance benefit to offer more tobacco cessation assistance to state employees has helped an estimated 570 state workers successfully quit using tobacco. The Oklahoma State Department of Health estimates this action has resulted in about $2.2 million in annual savings, or $3,800 per successful quitter, through reduced health care costs and increased employee productivity, 8/7/08

Smokers to burn more cash By John O'Connor, The State (Columbia)
South Carolina public employees who smoke - or whose insured dependents smoke - will have to pay $25 a month more for health insurance than non-smokers, under a change approved Thursday by the State Budget and Control Board. Read More

A Practical Guide to Working with Health-Care Systems on Tobacco-Use Treatment: This guide provides key information and practical advice for public health professionals and employers.

Study Supports Health Benefits Of Smoking Ban: Hospital Admissions Fall 17% After Scottish Law Enacted; Businesses Balk at Restrictions- As posted by the Wall Street Journal, 7/31/08.

National EX Campaign Promotes Smoking Cessation - An alliance of national organizations and state health agencies launched a national campaign designed to guide smokers to tobacco cessation resources, the Charlotte Observer reports. http://www.rwjf.org/programareas/features/digest.jsp?c=EMC-ND141&pid=1141&id=7535

Marguerite E. Burns, Timothy W. Bosworth, and Michael C. Fiore Insurance Coverage of Smoking Cessation Treatment for State Employees Am J Public Health 94: 1338-1340.

Franks P, Jerant AF, Leigh JP, et al. Cigarette Prices, Smoking, and the Poor: Implications of Recent Trends. AM J Public Health. 2007;97:1873-1877.

U.S. Department of Health and Human Services. With Understanding and Improving Health and Objectives for Improving Health. In Healthy People 2010: Vol. 1 and Vol. 2. 2nd ed. Washington, DC: U.S. Department of Health and Human Services; 2000.

Outside resources
*NOTE: NCSL provides links to other Web sites from time to time for information purposes only. Providing these links does not necessarily indicate NCSL's support or endorsement of the site.

CDC's Tobacco Cessation Resources: http://www.cdc.gov/tobacco/quit_smoking/cessation/index.htm

US Dept. of Health & Human Services: You Can Quit Smoking Now!: Treating Tobacco Use and Dependence: 2008 Update includes new, effective clinical treatments for tobacco dependence and the latest information to help people quit smoking. Released May, 2008.

CMS Letter Encouraging Smoking Cessation Treatments: On March 22, 2007, Dennis Smith, the Director of CMS's Centers for Medicare & Medicaid Services, wrote to all State Medicaid Directors to highlight the importance of smoking cessation treatment. The letter cites CDC research that indicates "that smoking cessation treatment was among the top-ranked clinical preventive services determined to save health care costs."

Federal Trade Commission Cigarette Report: 2007 is the latest report detailing the annual consumption and industry promotion practices. Cigarette Report for 2004 and 2005. Washington, DC: Federal Trade Commission; 2007.

Saving Lives, Saving Money II: A study released November 29, 2007 by the American Legacy Foundation which asserts that effective smoking prevention and cessation programs could cut Medicaid costs by 5.6 percent.

Saving Lives, Saving Money: Why States Should Invest in a Tobacco Free Future: Publication released in 2002 by the American Legacy Foundation. Part one of the report highlights four successful state efforts in California, Massachusetts, Maine and Florida. Part two reports that a sustained minimal investment in comprehensive tobacco control will save state and local governments money by preventing tobacco-related illnesses and thereby avoiding related treatment costs.

Harvard University study Investigates quitting as a group maybe easier: Smoking is addictive but quitting is contagious. Source: Harvard University, May 19, 2008

Back to Tobacco Page

© 2008 National Conference of State Legislatures, All Rights Reserved

Denver Office: Tel: 303-364-7700 | Fax: 303-364-7800 | 7700 East First Place | Denver, CO 80230 | Map
Washington Office: Tel: 202-624-5400 | Fax: 202-737-1069 | 444 North Capitol Street, N.W., Suite 515 | Washington, D.C. 20001