Health insurance plans extend efforts to end tobacco use

Nearly three-quarters of all health insurance plans included in a new survey rely on evidence-based clinical guidelines to address tobacco use, and almost all plans, 98 percent, provide full coverage for at least one type of smoking cessation intervention.

Those are among the results of a new study released today by America's Health Insurance Plans, and published in the journal Preventing Chronic Disease.

"These results show that health insurance plans have clearly expanded their leadership role in fighting the adverse health effects of tobacco use," said Karen Ignagni, AHIP president and CEO.

The study shows significant increases between 1997 and 2002 in the percentage of plans with strategies to address relapse after childbirth, as well as smoking cessation during treatment for chronic illness and following a heart attack. Approximately 47 percent of plans in the latest survey reported having a specific strategy to address smoking cessation during postpartum visits and following a heart attack, and 52 percent of plans reported having a specific strategy to address smoking cessation during treatment for chronic illness, more than double the rates from five years earlier.

According to Ignagni, the health consequences of smoking have made prevention and treatment of tobacco use a priority among health insurance plans.

"As medical professionals learn more about what works to help people quit smoking, health plans are increasingly incorporating this knowledge into their coverage decisions," Ignagni said.

Key findings of the study:

• Most of the nation's health plans (71 percent) in 2002 reported having written clinical guidelines for smoking cessation.
• In 2002, 72 percent of the plans in the survey used one or more tools to help identify plan members who smoke, up from 15 percent in 1997, and 27 percent in 2000. Most plans used a combination of health risk appraisals, member surveys and medical record reviews to identify candidates for smoking cessation; only 6 percent used enrollment information.
• Approximately 89 percent of plans in 2002 reported providing full coverage for at least one type of pharmacotherapy used for smoking cessation, more than triple the number reporting similar coverage in 1997.
• Approximately 52 percent of plans reported providing full coverage in 2002 for telephone counseling for smoking cessation, and 41 percent provided full coverage for face-to-face counseling.

The recently released survey builds on a series of studies conducted by the association over the last six years. These studies offer a comprehensive assessment of tobacco control practices of health plans at a national level.

The 152 health plans that completed the 2002 survey represented more than 43.5 million members nationwide.

The survey was conducted by AHIP's national technical assistance office as part of the Addressing Tobacco in Managed Care program, and was supported through an unrestricted educational grant from The Robert Wood Johnson Foundation.

AHIP's long-term tobacco control program advances the integration of the tobacco cessation and prevention programs into routine health care by increasing the number and quality of tobacco control initiatives.

Preventing Chronic Disease is a peer-reviewed journal published by Centers for Disease Control and Prevention. The article appears in the October 2004 issue of the journal, and can be accessed online at www.cdc.gov/pcd/issues/2004/oct/04_0021.htm.