Morbidity and Mortality Weekly Reports (MMWRs)

State Medicaid Coverage for Tobacco-Dependence Treatments—United States, 1994–2001

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Because rates of smoking are highest among people living in poverty, the negative health effects of tobacco use are of major concern for State Medicaid programs.
Medicaid recipients have approximately 50% greater smoking prevalence than the overall U.S. population.
In 2000, approximately 11.5 million (36%) adult Medicaid recipients smoked cigarettes.

In 2001, 15 states offered no coverage for tobacco-dependence treatment under Medicaid, and only Oregon provided coverage for all treatment options recommended by the PHS Clinical Practice Guideline.
The number of Medicaid programs providing some coverage for counseling or medication increased from 34 (67%) in 2000 to 36 (71%) in 2001.
In 2001, only 10 states offered some form of tobacco-dependence counseling services, the primary recommendation for pregnant women.
Only 12 (33%) state Medicaid programs that provided coverage for tobacco-dependence treatment benefits informed their recipients that these benefits were available to them.
Of the 36 states that offered any coverage in 2001, all but one covered at least one pharmacotherapy treatment (i.e., Zyban®, Wellbutrin®, buproprion sustained release, nicotine nasal spray, nicotine inhaler, nicotine patch, or nicotine gum).
Data show that co-payments result in decreased use of treatment; however, 16 states required some form of patient cost sharing, that ranged from $0.50 to $3.00 per prescription.
According to the Public Health Service (PHS) Clinical Practice Guideline, Treating Tobacco Use and Dependence, treatment with either counseling or medication doubles quit rates.
The Guide to Community Preventive Services recommends reducing the cost of tobacco-dependence treatments, especially in low-income populations, to increase the use of treatment by smokers attempting to quit and the number of successful quitters.

Page last reviewed 02/28/2007
Page last modified 02/28/2007