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Tobacco Cessation

Tobacco Cessation: State and Federal Efforts to Help

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.

 

Federal Update

August, 2012: List of FDA-approved products that may help you quit. 

February, 2012: Cigarette Packaging and Advertising Compliance Update – Impact of Ongoing Litigation.

NCSL Resources

NCSL LegisBrief about Tobacco Cessation in State Medicaid and Employee Programs January, 2011.

NCSL LegisBrief about State Wellness Initiatives March, 2010.

NCSL Fall Forum Session, Friday, Dec. 12, 2008-  Kicking the Habit: Saving Lives and Money through Tobacco Cessation Programs  Listen to the Session

States are looking for cost savings in state employee and Medicaid health care programs. Some states have saved money and lives through tobacco cessation progams for state employees and Medicaid recipients. Hear from states with success stories and learn how a small step can save big bucks.

 


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

Y- pregnant women

Alaska *

Y

Y

Y- individual therapy

Arizona*

Y

Y

N

Arkansas *

Y

Y

Y

California

Y

Y

Y- varies by plan

Colorado *

Y

Y

Y- varies by plan

Connecticut

N

N

N

Delaware

Y

Y

N

District of Columbia *

Y

Y

N- varies by plan

Florida *

Y

Y

Y- varies by plan

Georgia *

N

N

N

Hawaii *

Y

Y

N- varies by plan

Idaho

Y

Y

Y- group therapy

Illinois

Y

Y

N

Indiana *

Y

Y

Y

Iowa*

Y

Y

Y- individual therapy

Kansas

Y

Y

N

Kentucky*

N

N

Y

Louisiana

Y

Y

N

Maine *

Y

Y

Y- individual therapy

Maryland *

Y

Y

Y- varies by plan

Massachusetts *

Y

Y

Y

Michigan *

Y

Y

N

Minnesota *

Y

Y

Y

Mississippi

Y

Y

Y

Missouri *

N

N

N

Montana *

Y

Y

Y- individual therapy

Nebraska

Y

Y

Y- individual therapy

Nevada *

Y

Y

Y- under certain conditions

New Hampshire *

Y

Y

Y- varies by plan

New Jersey

Y

Y

Y- varies by plan

New Mexico

Y

Y

Y- varies by plan

New York *

Y

Y

Y- individual therapy

North Carolina

Y

Y

Y- individual therapy

North Dakota *

Y

Y

Y

Ohio *

Y

Y

N

Oklahoma *

Y

Y

Y- individual therapy

Oregon *

Y

Y

Y

Pennsylvania

Y

Y

Y

Puerto Rico*

N

N

N

Rhode Island *

Y

Y

Y

South Carolina

Y

Y

Y- varies by plan

South Dakota *

N

Y

N

Tennessee *

N

N

N

Texas *

Y

Y

Y- varies by plan

Utah *

Y

Y

Y- pregnant women

Vermont *

Y

Y

N

Virginia

Y

Y

Y- varies by plan

Washington*

Y

Y

Y- varies by plan

West Virginia *

Y

Y

Y- varies by plan

Wisconsin *

Y

Y

Y- individual therapy, group varies

Wyoming *

Y

Y

Y- individual therapy

Source: Centers for Disease Control and Prevention, 2006. American Lung Association, 2008. Partnership for Prevention, 2010.

 

* Statewide public program available, coverage may vary from other programs. 

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

NEW Tobacco Cessation Leadership Network (TCLN) slide presentations from Roundtable Discussions on State Medicaid Cessation Programs: Click here for more information.


 Links to state-wide tobacco cessation programs:

Alabama: www.adph.org/tobacco
Alaska: http://www.hss.state.ak.us/dph/chronic/tobacco/
Arizona: www.ashline.org 
Arkansas: www.stampoutsmoking.com  
California: http://www.californiasmokershelpline.org/  or 1-800-NO-BUTTS
Colorado: www.tobaccofreecolorado.com
Connecticut: www.freeclear.com/quit-for-life/ or Callers can phone (866) 363-4224 (866-END-HABIT) Monday-Sunday: 8am-12am.
Delaware: www.dhss.delaware.gov/dph/dpc/quitline.html or 1-866-409-1858
Florida: www.flquitline.com
Georgia: www.livehealthygeorgia.org
Hawaii: www.callitquitshawaii.org
Idaho: www.bcidahofoundation.org/Programs/smoking_cessation_2004.asp or 1-888-280-2265
Illinois: www.quityes.org/ or 1-866-QUIT-YES
Indiana: www.indianaquitline.net
Iowa: www.quitlineiowa.com
Kansas: www.kdheks.gov/tobacco/cessation.html or 1-800-QUIT-NOW (784-8669)
Kentucky: www.gethealthy.ky.gov
Louisiana: http://tobaccofreeliving.org/home/section/15/1210/ or 1-800-QUIT-NOW
Maine: www.tobaccofreemaine.org
Maryland: www.smokingstopshere.com
Michigan: www.tobaccofreemichigan.org
Massachusetts: www.trytostop.org and www.quitworks.org
Minnesota: www.quitplan.com
Mississippi: http://www.quitlinems.com/ or 1-800-QUIT-NOW
Missouri: www.dhss.mo.gov/SmokingAndTobacco/
Montana: http://tobaccofree.mt.gov/
Nebraska: http://www.hhs.state.ne.us/tfn/ces/ or 1-800-QUIT-NOW (784-8669)
Nevada: www.livingtobaccofree.com
New Hampshire: www.trytostop.org
New Jersey: www.nj.quitnet.com or 1-866-NJSTOPS
New Mexico: www.quitnownm.com
New York: www.nysmokefree.com
North Carolina: http://www.quitlinenc.com/ or 1-800-QUIT-NOW (784-8669)
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
Puerto Rico: 1-877-335-2567
Rhode Island: http://www.trytostop.org
South Carolina: www.scdhec.gov/health/chcdp/tobacco/quitforkeeps.htm or 1-800-QUIT-NOW (784-8669)
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
Virginia: www.vahealth.org/cdpc/TUCP/ or www.vahealth.org/cdpc/TUCP/QuitNow.htm or 1-800-QUIT NOW (1-800-784-8669)
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 or reports that may be available for a fee, registration, or membership basis:

The Return on Investment of a Medicaid Tobacco Cessation Program in Massachusetts (January 2012) - A study by George Washington University showing the ROI of a comprehensive tobacco cessation program for people in Medicaid. This study estimates the costs of the tobacco cessation benefit and the short-term Medicaid savings attributable to the aversion of inpatient hospitalization for cardiovascular conditions.

Webinar: Partnership for Prevention is pleased to sponsor a webinar highlighting a new study on the Massachusetts Medicaid tobacco cessation benefit. Research for the project was undertaken by health economists at The George Washington University School of Public Health and Health Services, with funding from Partnership for Prevention. Results from the study show a significant positive return on investment when compared to the costs of implementing the Massachusetts tobacco control program.  Because advocates in many states are currently attempting to expand tobacco cessation treatment coverage for Medicaid beneficiaries, the speakers will also discuss the policy implications of this research. Additionally, the program will spotlight New York State, which has had recent success expanding coverage.  An accompanying ActionToQuit policy paper can be downloaded here. Webinar link will be provided when it becomes public.

Save Lives and Money - Help People on Medicaid Quit Tobacco (July 2010) - A guide from Partnership for Prevention and the American Lung Association urging states to cover all treatments people on Medicaid need to quit tobacco.   

Save Lives and Money - Help State Employees Quit Tobacco (January 2010) - A guide from Partnership for Prevention and the American Lung Association urging states to cover all treatments state employees need to quit tobacco.  

Study Suggests Online, Computer-Based Cessation Programs Effective at Curbing Smoking
A meta-analysis published in the Archives of Internal Medicine suggests that computer- or Web-based smoking cessation programs can effectively aid smokers in their efforts to quit, United Press International reports.

Monetary Rewards for Smoking Cessation Proves Successful A study in the New England Journal of Medicine suggests that employer-based smoking cessation programs that provide financial incentives are most effective at persuading workers to quit smoking, the Associated Press reports.

Report from Campaign for Tobacco Free Kids: A Decade of Broken Promises, the 1998 State Tobacco Settlement 10 Years Later.  Provided state by state information on how states are spending MSA payments and other state cessation and prevention program fiscal information.

Report from the American Lung Association: Helping Smokers Quit: State Cessation Coverage report also provides an index of cessation services and treatments offered in each state. This information can be found by visiting the press release page or http://www.lungusa.org/. 11/08

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.

NEW Tobacco Technical Assistance Consortium’s Using Best Practices: Practical Lessons in Building and Sustaining Comprehensive Tobacco Control Programs

NEW CDC Report on State-Specific Prevalence and Trends in Adult Cigarette Smoking – United States, 1998-2007

Great American Smokeout: Great American Smokeout—November 20, 2008

CDC Report on Cigarette Smoking Among Adults—United States, 2008

American Lung Association: www.lungusa.org

American Lung Association's State Tobacco Cessation Cessation Database or search the database here. Cessation Fact Sheets & Reports available here.

CDC's Tobacco Cessation Resources: http://www.cdc.gov/tobacco/quit_smoking/cessation/index.htm
CDC's Best Practices for Comprehensive Tobacco Control Programs, 2007 and Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000–2004

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:  2006 is the latest report detailing the annual consumption and industry promotion practices.  Washington, DC:  Federal Trade Commission; 2009.

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 


SEPTEMBER 2008 ARCHIVED INFO:  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:
 

 

 

State Employee Tobacco Cessation programs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Back to Tobacco Page

 

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