CDC: Medicaid Could Do More to Fight Smoking

Survey Shows Only 8 State Programs Cover All Recommended Drug and Counseling Treatments

Medically Reviewed by Laura J. Martin, MD on October 21, 2010
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Oct. 21, 2010 -- Most Medicaid programs in the U.S. offer at least some form of health care coverage to enrollees who are trying to quit smoking, but in many states more could be done to help people kick the habit, the CDC says.

In its Morbidity and Mortality Weekly Report for Oct. 22, the CDC says it surveyed Medicaid programs in all 50 states and Washington, D.C., and found that 47 offered some coverage for dependence treatment in 2009.

The report says 37% of Medicaid enrollees smoke, compared to 21% of the overall adult population. Only eight state programs offered coverage of all recommended drug and counseling treatments; 43 programs would need to add additional tobacco-dependence treatments in order comply with U.S. Preventive Services Task Force recommendations.

The CDC says smoking-related medical costs account for 11% of Medicaid expenditures.

Of the 51 Medicaid programs surveyed, 47 provided tobacco-dependence treatment coverage for some enrollees and 38 covered at least one treatment for all Medicaid enrollees. Four states -- Connecticut, Georgia, Missouri, and Tennessee -- offered no coverage for enrollees.

Survey Methods

Medicaid personnel were asked to fill out online surveys of 45 questions regarding treatment coverage, limitations of coverage, outreach activities, and related subjects.

Coverage for all Medicaid enrollees was reported for the nicotine patch for 34 programs, while 33 covered bupropion (Zyban), 32 covered nicotine gum, and 32 covered varenicline (Chantix).

The Morbidity and Mortality Weekly Report also states that:

  • 28 programs covered a nicotine nasal spray
  • 27 programs paid for nicotine inhalers
  • 25 covered nicotine lozenges

“Insurers that provide adequate access and support for persons seeking to quit smoking can improve cessation rates substantially, with potential for considerable improvement in public health and reduction in medical expenditures,” the report's authors write.

Recent federal policy is increasing access to programs to help people quit smoking. The Affordable Care Act, for instance, mandates Medicaid programs to cover tobacco-treatment coverage for pregnant women, and that requirement went into effect Oct. 1.