The Role of Health Care Systems in Increased Tobacco Cessation

Abstract

Health care delivery systems are critical components of tobacco cessation efforts. This review summarizes recent evidence in sup-

Tobacco Control in the United States--Recent Progress And Opportunities

“…National data show an increase in reported advice to quit smoking from a health-care provider from 40% in the mid-1990s to 61% in the mid-2000s, with similar increases across racial and ethnic groups. 76,77 The 2006 Healthcare Effectiveness Data and Information Set (HEDIS) report, from the National Committee for Quality Assurance, showed 71% of smokers or recent quitters who had private insurance received advice to quit smoking from their health-care provider, and 39% reported discussing smoking cessation strategies; corresponding rates among Medicaid recipients were lower at 66% and 34%, respectively. 78 However, the use of evidence-based treatments in quit attempts remains low, with an estimated 22% of smokers trying to quit by using cessation aids.…”

“…However, even insured smokers may bear a significant portion of the cost of pharmacotherapy because of deductibles and copayments or, in some cases, because of noncoverage. 76,80 In some cases, coverage is extended only to certain groups of smokers. For example, Medicare covers smoking-cessation counseling and pharmacotherapy (excluding over-the-counter treatment) for seniors with tobacco-related illnesses, and in some states, the Medicaid program covers treatments only for pregnant women.…”

“…For example, Medicare covers smoking-cessation counseling and pharmacotherapy (excluding over-the-counter treatment) for seniors with tobacco-related illnesses, and in some states, the Medicaid program covers treatments only for pregnant women. 76,81,82 Among national surveys to assess health-insurance coverage of any tobacco-dependence treatments, estimates range from 88% among health-maintenance plans to 20% among employer-provided plans. 83,84 State-specific estimates may be higher; in California, employer-sponsored coverage of any treatment increased from 44% in 2000 to 57% in 2005, while coverage for all forms of treatment increased from 11% to 22% during the same time period.…”

Implementing point of care “e-referrals” in 137 clinics to increase access to a quit smoking internet system: the Quit-Primo and National Dental PBRN HI-QUIT Studies

“…Effective smoking cessation programs have the potential to dramatically decrease health care utilization and costs [41][42][43][44]. A cost-benefit analysis found that the ratio of benefits to cost varies from US$0.80 to US$2.40 saved per dollar spent on smoking cessation programs, depending upon the type of intervention [45].…”

Supporting implementation of evidence-based behavioral interventions: the role of data liquidity in facilitating translational behavioral medicine

“…Behavioral interventions, such as smoking cessation strategies, increasingly rest upon a solid body of research evidence demonstrating their efficacy. Yet translational behavioral medicine will not become a reality until we can ensure that these evidence-based interventions move from the research realm into practice, and that they are, in actuality, (a) implemented in clinical practice of behavioral medicine, with sufficient quality to benefit individual patients, and (b) incorporated into the knowledge base supporting behavioral medicine, such that they inform care for relevant populations [6][7][8][9].…”