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2 tables omitted
Tobacco use is the leading preventable cause of death in the United
States.1 One of the national health objectives for 2010 is to increase
insurance coverage of evidence-based treatment for nicotine dependence (i.e.,
total coverage of behavioral therapies and Food and Drug Administration [FDA]–approved
pharmacotherapies) in Medicaid programs from 36 states to all states and the
District of Columbia (DC) (objective 27.8).2 To increase both the
use of treatment by smokers attempting to quit and the number of smokers who
quit successfully,3,4 the Guide to Community
Preventive Services5 recommends reducing the "out-of-pocket"
cost of effective tobacco-dependence treatments (i.e., individual, group,
and telephone counseling, and FDA–approved pharmacotherapies) for smokers.
The 2000 Public Health Service (PHS) Clinical Practice Guideline supports expanded insurance coverage for tobacco-dependence treatments.6 In 2000, approximately 32 million low-income persons in the United
States received their health insurance coverage through the federal-state
Medicaid program7; 11.5 million (36%) of these persons smoked (CDC,
unpublished data, 2000). The amount and type of coverage for tobacco-dependence
treatment offered by Medicaid has been reported for 1998 and 2000 from state
surveys conducted by the Center for Health and Public Policy Studies (CHPPS)
at the University of California, Berkeley.8 All states and DC were
re-surveyed in 2001 about amount and type of coverage, and level of coverage
since 1994. This report summarizes the results of the survey, which indicate
that the number of Medicaid programs providing some coverage for tobacco-dependence
counseling or medication increased from 34 in 2000 to 36 in 2001, but only
one state offered coverage for all the counseling and pharmacotherapy treatments
recommended by the 2000 PHS guideline. If the 2010 national health objective
is to be achieved, Medicaid coverage for treatment of tobacco dependence should
be increased dramatically.
State Medicaid Coverage for Tobacco-Dependence Treatments—United States, 1994-2001. JAMA. 2003;290(3):327–328. doi:10.1001/jama.290.3.327
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