'Model' tobacco cessation program reduces smoking rate by 26%

Nov 19 2009

A "model" tobacco cessation benefit offered to Massachusetts' Medicaid participants has produced an astounding 26% drop in smoking rates in only two and a half years, and has already been linked to decreases in heart attacks, hospitalizations for asthma and COPD, and a significant decrease in birth complications.

Researchers from the Massachusetts Tobacco Cessation and Prevention Program (MTCP) found that up to 38% fewer MassHealth cessation benefit users were hospitalized for heart attacks in the first year after using the benefit, and that 18% fewer benefit users visited the emergency room for asthma symptoms in the first year after using the benefit. Researchers also found that there were 12% fewer claims for adverse maternal birth complications since the benefit was implemented.

The Massachusetts Executive Office of Health and Human Services said more than 75,000 people -- a full 40% of MassHealth members who smoke -- have used the benefit to try to quit smoking. Cost savings are being studied, and all indications suggest they will be significant.

"It is clear from these latest findings that the Commonwealth's efforts to help people quit smoking is a sound investment," Executive Office of Health and Human Services Secretary JudyAnn Bigby said. "I have requested that a full analysis of the cost savings reach my desk by June 30, 2010."

Three former U.S. Surgeons General and a national coalition of business, labor, health care professionals and nonprofits have endorsed a nationwide call for action (www.ACTTIONtoquit.org) to increase access to tobacco cessation benefits for smokers who want to quit. The head of Partnership for Prevention, the disease prevention advocacy organization in Washington, D.C., that organized the national effort, said the Massachusetts experience makes a strong case for expanding cessation benefits.

"As the nation debates the future of its health care system, the national significance of this research cannot be understated," said Robert J. Gould, PhD, President and CEO of Partnership for Prevention, a national organization that advances policies and practices to prevent disease and improve the health of all Americans. "These findings demonstrate that prudent investments in preventive health today will have a dramatic and positive effect on our health care system tomorrow."

MTCP and MassHealth worked together to design a model benefit that includes all FDA-approved medications to quit smoking, behavioral counseling, and features very low co-pays to reduce barriers to access. Beginning in July 2006, MassHealth began providing coverage of smoking cessation as part of the state's health care reform initiative. MTCP promoted the new benefit through radio and transit ads and extensive community outreach. The benefit was introduced into an environment that encourages quitting smoking: Massachusetts has smoke-free workplaces, high cigarette taxes, and a non-smoking social norm, all of which contribute to smokers wanting to quit.

"The significance of this research demonstrates how important it is to provide comprehensive tobacco cessation services to smokers and to make sure they know about them," Department of Public Health Commissioner John Auerbach said. "We know that smokers who get support and use stop-smoking medicines like the patch are more than twice as likely to be able to quit for good as those who try to quit on their own. By introducing these benefits to members of MassHealth and making sure they know about them, we are helping people to break their nicotine addiction."

Smoking remains the number one preventable cause of illness and death in the Commonwealth and in the United States. More than 8,000 Massachusetts residents die annually from the effects of smoking, and tobacco use is associated with $4.3 billion in excess health care costs in Massachusetts each year.

"These early findings offer great promise," said Nancy Brown, National CEO of the American Heart Association. "Heart attack hospitalizations are expensive and take a financial and emotional toll on patients and their families."

"Massachusetts is leading the way in demonstrating that insurance coverage for smoking cessation quickly improves health and saves lives, and no doubt reduces health care costs as well," said Mathew L. Myers, President of the Campaign for Tobacco-Free Kids. "This evidence couldn't be more timely and underscores why it is critical that health reform legislation approved by Congress invest in prevention and require cessation coverage, including for everyone in Medicaid. It is also critical that Massachusetts continue to invest in tobacco prevention and cessation programs."

In Massachusetts, 77% of adult cigarette smokers want to quit, 60% of smokers have tried to quit within the past year, and 44% report that they plan to quit in the next 30 days.

"By providing MassHealth members with barrier-free access to cessation services we are beginning to see cost savings from a decrease in spending for tobacco related illnesses," said Terry Doughtery, EOHHS Assistant Secretary for Administration and Operations and Interim Director of the Massachusetts Office of Medicaid. "Smoking rates among this population had been stagnant for the past decade. Reducing smoking rates among our members was our primary goal, and after only 2.5 years of providing our members with cessation services, the smoking rate has declined by nearly 26 percent."