American Lung Association Report Says U.S. at Tipping Point for Policies that Help Smokers Quit

(December 3, 2012)

 Brookfield, WI – The United States is at a tipping point when it comes to policies that help smokers quit, according to the American Lung Association’s “Helping Smokers Quit: Tobacco Cessation Coverage 2012” report.  Released today, the annual report provides a comprehensive review of each state’s tobacco cessation coverage and an up-to-date look at federal coverage and requirements under the Affordable Care Act. 

 “Over the next year key decisions will be made by the federal government and the states about whether or not they will help save lives, prevent disease and reduce health costs,” said Sue Swan, Executive Director at the American Lung Association in Wisconsin.  “We know that the vast majority of smokers want to quit, but too many are still not getting the help they need. States and the federal government can reduce the enormous health burden of tobacco use by providing access to proven interventions.”

The American Lung Association report shows that the federal government has missed several key opportunities to improve access to quit smoking medications and counseling.   The record for the states is mixed.  Wisconsin provides good coverage for Medicaid recipients, but still underfunds the state Quitline, the main sources of cessation counseling for most smokers.  This leads to reduced coverage and limited ability for smokers to access the service.

Wisconsin’s coverage:

Medicaid – provides coverage for all NRTs (nicotine replacement therapies) except for the NRT lozenge.  Chantix and Zyban, both requiring a physician’s prescription, are covered.  Group counseling varies by plan.

State Employee Health plan – covers all NRTs except gum and lozenges as well as Chantix and Zyban.  Does not include group or phone counseling, although free counseling is available through the Quitline and the American Lung Association HelpLine.

Quitline – The Quitline is funded at 73 cents per smoker.  The Centers for Disease Control recommends $10.53 per smoker. 
 
Federal Coverage:

On November 26, the U.S. Department of Health and Human Services (HHS) published a proposed rule that requires the Essential Health Benefit coverage mandated by the  Affordable Care Act to cover preventive services, including tobacco cessation.  However, because HHS has not yet defined what insurers must include as part of a tobacco cessation benefit, the Administration missed a crucial opportunity.  Now, each state can choose its own benchmark plan, which will then serve as the Essential Health Benefit standard for plans in that state’s health insurance exchange.  Until HHS officially defines a comprehensive tobacco cessation benefit, it has missed a crucial opportunity to provide many smokers with new access to help quitting, and to establish tobacco cessation as a truly essential health benefit for all health insurance coverage.

HHS’s failure to act provides an opportunity for states, according to the report.  Policymakers can now help smokers quit by including comprehensive tobacco cessation benefits as they implement state health insurance exchanges and Medicaid expansions. 

Tobacco use is the leading preventable cause of death in the United States.  The economic costs in the U.S. due to tobacco total $193 billion annually; in Wisconsin tobacco use costs $4.5 billion annually.  Providing comprehensive quit-smoking treatments is crucial in both saving lives and curbing health costs – one recent study showed that providing this help has a 3-to-1 return on investment. 

“Giving all smokers access to a comprehensive cessation benefit is not only the right thing to do, it’s the smart thing to do,” said Swan. “The bottom line is that quitting smoking saves lives and saves money.”

Editor’s Note: Available as a standalone graphic is “Tobacco Cessation Treatment: What is covered?”— the American Lung Association’s breakdown of what the biggest health insurance programs cover for tobacco cessation and how the Affordable Care Act changes coverage.

About the American Lung Association in Wisconsin: Our mission is to save lives by improving lung health and preventing lung disease. With your generous support, the American Lung Association is "Fighting for Air" through research, education and advocacy. For more information about the American Lung Association or to support the work it does, call 1-800-LUNG-USA (1-800-586-4872) or visit www.LungWI.org.