title: How Medicaid and Other Public Policies Affect Use of Tobacco Cessation Therapy, United States, 2010-2014.
abstract: State Medicaid programs can cover tobacco cessation therapies for millions of low-income smokers in the United States, but use of this benefit is low and varies widely by state. This article assesses the effects of changes in Medicaid benefit policies, general tobacco policies, smoking norms, and public health programs on the use of cessation therapy among Medicaid smokers.
  
  
  
  We used longitudinal panel analysis, using 2-way fixed effects models, to examine the effects of changes in state policies and characteristics on state-level use of Medicaid tobacco cessation medications from 2010 through 2014.
  
  
  
  Medicaid policies that require patients to obtain counseling to get medications reduced the use of cessation medications by approximately one-quarter to one-third; states that cover all types of cessation medications increased usage by approximately one-quarter to one-third. Non-Medicaid policies did not have significant effects on use levels.
  
  
  
  States could increase efforts to quit by developing more comprehensive coverage and reducing barriers to coverage. Reductions in barriers could bolster smoking cessation rates, and the costs would be small compared with the costs of treating smoking-related diseases. Innovative initiatives to help smokers quit could improve health and reduce health care costs.
authors: Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, NW, 6th Floor, Washington, DC 20052. Email: lku@gwu.edu.
authors: Leighton
authors: L
authors: Ku
authors: George Washington University, Washington, DC.
authors: Erin
authors: E
authors: Brantley
authors: NORC, University of Chicago, Chicago, Illinois.
authors: Tyler
authors: T
authors: Bysshe
authors: George Washington University, Washington, DC.
authors: Erika
authors: E
authors: Steinmetz
authors: George Washington University, Washington, DC.
authors: Brian K
authors: BK
authors: Bruen
mesh_terms: D003376:Counseling / Q000191:economics*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D008484:Medicaid; D011634:Public Health; D011640:Public Policy; D012044:Regression Analysis; D012907:Smoking / Q000628:therapy*; D020340:Tobacco Use Cessation / Q000191:economics*; D014481:United States