Prevention Matters

Forty-three states now cover some form of cessation treatment for Medicaid beneficiaries, up from 23 states in 1998, according to the Nov. 6 issue of Morbidity and Mortality Weekly Report (MMWR), which summarizes coverage of tobacco dependence treatment under the Medicaid program, reported that. However, only six states cover all of the effective pharmacotherapies and individual and group counseling.

Smoking rates among Medicaid enrollees are much higher than among the general population – 4.7 million smokers. This represents 33% of the total Medicaid population and adds to nearly $22 billion in annual Medicaid expenditures related to smoking. Numerous studies have found that tobacco cessation treatments are highly cost effective. Yet many barriers exist, preventing greater access to those who need and want help to quit tobacco use.

Partnership for Prevention and the Call for ACTTION initiative encourage the federal government and states to implement the updated 2008 Public Health Service Clinical Practice Guidelines which call for access to comprehensive coverage of all effective treatments – counseling and medication without barriers and limitations.

Diane M. Canova
Managing Senior Fellow
 & Senior Program Officer
Partnership for Prevention

A new Institute of Medicine report further clinches the case for linking second-hand tobacco smoke to cardiovascular disease.  An IOM committee found that data consistently demonstrates that secondhand-smoke exposure increases the risk of coronary heart disease and heart attacks and that smoking bans reduce this risk. Given the prevalence of heart attacks, and the resultant deaths, the committee found smoking bans can have a substantial impact on public health.

"The IOM study underscores the 2006 declaration by Surgeon General Richard Carmona that when it comes to second-hand smoke, 'the debate is over, the evidence is clear,'" said Partnership for Prevention President Robert J. Gould.

"Most importantly, the report clearly re-iterates that the damage from second-hand smoke does not require years of exposure," he continued. "The effects are immediate, and smokefree laws quickly reduce heart attacks among non-smokers.

"The science cannot and must not be ignored," Gould said. "We hope policymakers and employers across the country will take immediate action to protect the public from detrimental effects of second-hand smoke in all public spaces and workplaces. We also hope that citizens wll take this science 'to heart' and make their homes tobacco free."

Partnership for Prevention is a membership organization of business, nonprofit and government leaders working to make evidence-based disease prevention and health promotion a national priority.  A year ago, Partnership assembled a naitonal working group that issued a call to action (www.acttiontoquit.org) to provide smokers who want to quit with accress to a comprehensive range of evidence-based cessation treatment.

"Since smokefree policies encourage tobacco users to make quit attempts, it is important for such policies to be accompanied by improved access to a wide range of evidence-based treatments," Gould said. "Quitting smoking is very difficult for most people, and not all treatments work the same for all people,"

Shortly after President Obama agreed to remove family planning funding from the economic stimulus package that's before Congress, various forces began pushing him to do the same thing with tobacco cessation programs. The Senate version of the package contains $75 million for telephone quitlines and other cessation programs, which critics are deriding as pork.

Partnership President Corinne G. Husten, MD, MPH, today urged Senators overseeing the health section of the package to retain this funding on the grounds that the funding is good fisal policy as well as good public health policy. She said the programs would create jobs and help rebuild the public health infrastructure.

"Funding additional quitlines and cessation programs will help provide more of the services needed to empower people to quit smoking," Husten said in a letter to Sens. Tom Harkin, D-Iowa, and Arlen Specter. "Doing so will produce jobs to staff and promote the quitlines and other cessation programs. Given that smoking is responsible for over 400,000 deaths each year in the United States and for $193 billion annually in healthcare costs and lost worker productivity, this is no small matter."

Husten said the funding is consistent with the Center for Disease Control and Prevention’s (CDC) Best Practices, which calls for increasing support for state quitlines so that they have the infrastructure to provide comprehensive treatment to at least 10% of all tobacco users each year. She said it was also consistent with a Call for ACTTION (Access to Cessation Treatment for Tobacco In Our Nation) by a coalition of major business, labor, insurance, health care, and government institutions. The call is a plan to provide every American with access to comprehensive tobacco cessation treatment services by the year 2020.