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September 8, 2000
CDC, Office on Smoking and Health
(770) 488–5493
Fact Sheet: Advice to Quit Smoking in
Medicare Managed Care
Older smokers are at greater risk for smoking-related disease such as cardiovascular
disease, stroke, cancer, and respiratory disease.
- In 1998, the prevalence of daily cigarette smoking was 36.7% among Medicare managed care
enrollees aged 55-64, 15.1% among persons aged 65-74, 9.1% among persons aged 75-84, and
4.5% among persons aged 85 and older.
- Medicare managed care enrollees are more likely to visit a physician or healthcare
provider than other smokers; however, only 71% of older smokers receive advice to quit
smoking.
- For those enrolled in a Medicare managed care plan, who reported any smoking in the past
12 months, the advice to quit increased with the number of visits to physicians or
healthcare providers. An estimated 61.5% who made at least one visit in the past 12 months
reported receiving advice to quit, while 76.2% who made five or more visits received
advice to quit.
- African Americans (67.8%) and Hispanics (65.4%), who are enrolled in the Medicare
managed care plan were less likely to receive advice to quit compared with older whites
(72.2 %). However, Asian Pacific Islanders (54%) reported receiving less advice than all
racial/ethnic groups on Medicare. For both Hispanic and Asian Americans, language barriers
may play an important role in the lower rates of receiving advice to quit from physicians
and healthcare providers.
- Smokers aged 75 and older, who are enrolled in a Medicare managed care plan, were less
likely to receive advice to quit smoking than younger smokers despite the health benefits
they would experience if they quit. Older adults smokers with a household income of less
than $10,000 were less likely to receive advice to quit.
- Tobacco-use treatment guidelines published by the Public Health Service provides a
blueprint for healthcare professionals and health insurance providers in implementing
appropriate medical services that will help treat nicotine addiction. The recently
released "Reducing Tobacco Use: A Report of the Surgeon General," (http://www.osophs.dhhs.gov/library/tobacco_use/)
provides further evidence that physicians advising their patients to quit smoking, can
produce cessation rates of 5% to 10% per year. Combining behavioral counseling and
pharmacologic treatment can produce quit rates of 20-25% in one year.
- Increasing delivery of smoking cessation advice to 90% of Medicare recipients, who still
smoke, could encourage an additional 25,000 smokers to quit each year.
- Behavior change such as smoking cessation, even late in life, reduces mortality and can
result in improved and enhanced quality of life for older smokers.
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