title: Medicaid Tobacco Cessation: Big Gaps Remain In Efforts To Get Smokers To Quit.
abstract: Medicaid enrollees are about twice as likely as the general US population to smoke tobacco: 32 percent of people in the program identify themselves as smokers. This article provides the first data about the effectiveness of state Medicaid programs in promoting smoking cessation. Our analysis of Medicaid enrollees' use of cessation medications found that about 10 percent of current smokers received cessation medications in 2013. Every state Medicaid program covers cessation benefits, but the use of these medications varies widely, with the rate in Minnesota being thirty times higher than that in Texas. Most states could increase their efforts to help smokers quit, working with public health agencies, managed care plans, and others. In 2013 Medicaid spent $103 million on cessation medications-less than 0.25 percent of the estimated cost to Medicaid of smoking-related diseases. Additionally, states that have not expanded Medicaid eligibility in the wake of the Affordable Care Act have higher smoking prevalence and lower utilization rates of cessation medication, compared to expansion states. Given these factors, nonexpansion states will have a greater public health burden related to smoking. Medicaid and public health agencies should work together to make smoking cessation a priority for Medicaid beneficiaries.
authors.affiliation: Leighton Ku (lku@gwu.edu) is a professor of health policy and management and director of the Center for Health Policy Research at the George Washington University, in Washington, D.C.
authors.forename: Leighton
authors.initials: L
authors.lastname: Ku
authors.affiliation: Brian K. Bruen is a lead research scientist and lecturer in the Department of Health Policy and Management at the George Washington University.
authors.forename: Brian K
authors.initials: BK
authors.lastname: Bruen
authors.affiliation: Erika Steinmetz is a senior research scientist in the Milken Institute School of Public Health at the George Washington University.
authors.forename: Erika
authors.initials: E
authors.lastname: Steinmetz
authors.affiliation: Tyler Bysshe is a senior research assistant in the Milken Institute School of Public Health at the George Washington University.
authors.forename: Tyler
authors.initials: T
authors.lastname: Bysshe
mesh_terms: D000328:Adult; D016642:Bupropion / Q000191:economics* / Q000627:therapeutic use; D016208:Databases, Factual; D004363:Drug Utilization / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008484:Medicaid / Q000191:economics*; D008875:Middle Aged; D058991:Patient Protection and Affordable Care Act / Q000191:economics; D012189:Retrospective Studies; D018570:Risk Assessment; D020340:Tobacco Use Cessation / Q000191:economics* / Q000379:methods*; D014481:United States
chemical_list: D016642:Bupropion
keywords: Medicaid; Public Health; Tobacco/Smoking