Smokers trying to kick the habit in Georgia got a boost last November when their state became the latest to give Medicaid recipients access to tobacco cessation counseling and medications at little or no cost.
Nineteen states now cover both face-to-face counseling and all treatments approved by the U.S. Food and Drug Administration to help tobacco users enrolled in each state’s Medicaid program quit — a sign of momentum for anti-smoking campaigns. Although the number of American smokers has plummeted by more than half since 1965 — fewer than one in five people in the U.S. today use cigarettes — treating tobacco-related diseases costs taxpayers $22 billion a year in Medicaid costs.
That is because a large number of the dwindling smokers in America are also on Medicaid.
More than a third of the nearly 1.7 million people in Georgia who receive Medicaid also use tobacco, according to the state’s department of public health. In Ohio, which also began covering smoking cessation services in 2014, 42 percent of people on Medicaid smoke.
The high cost of medications and counseling is one of the biggest barriers to quitting for low-income smokers, said George Philippides, M.D., an American Heart Association volunteer and chief of cardiology at Newton-Wellesley Hospital in Massachusetts.
“People in the Medicaid population simply cannot afford them. It’s a barrier they face that other populations don’t,” he said.
Evidence is already emerging that offering practically free quit-smoking programs works.
Massachusetts expanded its Medicaid cessation coverage in 2006 and saw the smoking rate among Medicaid enrollees drop from 38 percent to 28 percent within about two years, a Centers for Disease Control and Prevention study found. Other research showed hospital admissions for heart attacks and other heart conditions fell by nearly half among the population using the benefit.
Philippides hopes such evidence quiets critics who say that disadvantaged populations do not want to quit.
“I expect many of the efforts being put forth by the state Medicaid programs will show that you can get people to participate if you take the time to educate them about the importance of quitting, as was done in Massachusetts,” he said.
The cessation coverage in Georgia comes on the heels of the state’s approval from the Centers for Medicare and Medicaid Services to get paid back some of the money it spends on its state-run “quitline,” a phone counseling service for smokers hoping to quit.
Last August, Georgia became one of a dozen states to get a Medicaid grant that will reimburse the quitline about $300,000 in the first year.
Increased funding for the quitline, which handles as many as 2,000 calls a day, will allow the state to better meet demand, said Jean O’Connor, J.D., Dr.P.H., chronic disease prevention director for the Georgia Department of Public Health, who led efforts to get the federal grant.
Combine that with Georgia’s expanded ability to cover FDA-approved tobacco cessation medications for all beneficiaries and “people on Medicaid are going to have everything they need from a clinical standpoint to quit successfully,” O’Connor said.
Smoking is the top preventable cause of death in the U.S. More than 480,000 Americans die each year from smoking and secondhand smoke, reports the CDC.
“There’s a huge need for this coverage,” Philippides said. “If you want to save lives and improve the health of loved ones, friends and the nation, then this is worth doing.”
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