Tobacco treatment services should be covered under Medicaid

Dc, Barker; Ct, Orleans; Hh, Schauffler

doi:10.1136/tc.7.1.92

Cited by 23 publications

(7 citation statements)

References 2 publications

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“…Several studies provide promising results for tailored interventions 83–87 as well as culturally tailored support geared to the needs of specific subgroups of smokers. 88,89 A meta-analysis showed that smokers who were provided with individually tailored self-help materials were more likely to succeed in their quit attempt than those who were provided nontailored materials (OR=1.42). 90 There is promising yet insufficiently robust evidence to estimate the effects of such programs.…”

Section: Policies To Improve Individually Tailored Stepped-care Apprmentioning

confidence: 99%

Boosting Population Quits Through Evidence-Based Cessation Treatment and Policy

Abrams

Graham

Levy

et al. 2010

American Journal of Preventive Medicine

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Only large increases in adult cessation will rapidly reduce population smoking prevalence. Evidence-based smoking-cessation treatments and treatment policies exist but are underutilized. More needs to be done to coordinate the widespread, efficient dissemination and implementation of effective treatments and policies. This paper is the first in a series of three to demonstrate the impact of an integrated, comprehensive systems approach to cessation treatment and policy. This paper provides an analytic framework and selected literature review that guide the two subsequent computer simulation modeling papers to show how critical leverage points may have an impact on reductions in smoking prevalence. Evidence is reviewed from the U.S. Public Health Service 2008 clinical practice guideline and other sources regarding the impact of five cessation treatment policies on quit attempts, use of evidence-based treatment, and quit rates. Cessation treatment policies would: (1) expand cessation treatment coverage and provider reimbursement; (2) mandate adequate funding for the use and promotion of evidence-based state-sponsored telephone quitlines; (3) support healthcare systems changes to prompt, guide, and incentivize tobacco treatment; (4) support and promote evidence-based treatment via the Internet; and (5) improve individually tailored, stepped-care approaches and the long-term effectiveness of evidence-based treatments. This series of papers provides an analytic framework to inform heuristic simulation models in order to take a new look at ways to markedly increase population smoking cessation by implementing a defined set of treatments and treatment-related policies with the potential to improve motivation to quit, evidence-based treatment use, and long-term effectiveness.

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Section: Policies To Improve Individually Tailored Stepped-care Apprmentioning

confidence: 99%

Boosting Population Quits Through Evidence-Based Cessation Treatment and Policy

Abrams

Graham

Levy

et al. 2010

American Journal of Preventive Medicine

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“…Current levels of coverage are based on McPhillips-Tangum 8 and Barker et al, 9 adjusted downward to reflect that many smokers are uninsured. We estimate that 3% of insurers cover Rx PTs and 2% also cover OTC PTs, 11% cover behavioural therapies only, 13% cover Rx PTs with behavioural therapies, and 2% cover any PT or behavioural therapy, for a total of 31% coverage.…”

Section: The Policy Modelmentioning

confidence: 99%

“…8 Even government payers, such as Medicaid and Medicare, often provide limited or no coverage. 9 Greater access to smoking cessation treatments and involvement of health care providers has the potential to increase treatment use. 5 10-13 In this paper, we present a simulation model of tobacco treatment policies.…”

mentioning

confidence: 99%

Examining the effects of tobacco treatment policies on smoking rates and smoking related deaths using theSimSmokecomputer simulation model

Levy

2002

Tob Control

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Objectives: To develop a simulation model to predict the effects of different smoking treatment policies on quit rates, smoking rates, and smoking attributable deaths. Methods: We first develop a decision theoretic model of quitting behaviour, which incorporates the decision to quit and the choice of treatment. A model of policies to cover the costs of different combinations of treatments and to require health care provider intervention is then incorporated into the quit model. The policy model allows for the smoker to substitute between treatments and for policies to reduce treatment effectiveness. The SimSmoke computer simulation model is then used to examine policy effects on smoking rates and smoking attributable deaths. Results: The model of quit behaviour predicts a population quit rate of 4.3% in 1993, which subsequently falls and then increases in recent years to 4.5%. The policy model suggests a 25% increase in quit rates from a policy that mandates brief interventions and the coverage of all proven treatments. Smaller effects are predicted from policies that mandate more restricted coverage of treatments, especially those limited to behavioural treatment. These policies translate into small reductions in the smoking rate at first, but increase to as much as a 5% reduction in smoking rates. They also lead to substantial savings in lives. Conclusions: Tobacco treatment policies, especially those with broad and flexible coverage, have the potential to increase smoking cessation substantially and decrease smoking rates in the short term, with fairly immediate reductions in deaths.M uch of the focus of recent tobacco control policies has been on youth prevention, 1 through such policies as media campaigns, reducing tobacco sales to youth, and school education programmes. These policies take considerable time to reduce overall smoking rates and smoking related deaths.2 Reducing the number of current smokers is necessary, however, to improve health in the immediate future. If current smokers quit, many of the health effects associated with smoking can be reversed. The recently released and updated Department of Health and Human Services guidelines 5 recommend that health care workers provide brief intervention and follow up, and that they advise the use of pharmacotherapy combined with behavioural treatment. Considerable research documents the effectiveness and cost effectiveness of treatment for tobacco use and dependence. Yet, access to treatment and involvement of health care workers is limited. Minimal interventions are not routinely provided by many health care providers.6 7 Less than half of managed care operations fully cover cessation classes or telephone counselling, and pharmacotherapy is rarely covered.8 Even government payers, such as Medicaid and Medicare, often provide limited or no coverage. Greater access to smoking cessation treatments and involvement of health care providers has the potential to increase treatment use.5 10-13 In this paper, we present a simulation model of tobacco treatment ...

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“…The evidence of tobacco's damage on health has gradually permeated the public understanding (Barker, Orleans, & Schauffler, 1998;Pierce et al, 1998;Smoking and health, 1964). Throughout the past decade, the public has been educated about the deceptions practiced by the tobacco industry, culminating in the revelation that seven American tobacco companies' chief executive officers lied to Congress about the addictive properties of nicotine (Campbell, 1994; "Deposition of Dr. J.…”

Section: An Evaluation Of Kingdon's Policy Theorymentioning

confidence: 98%

Putting Policy Theory to Work: Tobacco Control in California

Blackman

2005

Policy, Politics, & Nursing Practice

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Policy theory provides a useful lens for nurses evaluating how problems are understood and responded to within the policy arena. This article examines and critiques the agenda-setting model offered by John Kingdon. Furthermore, the theory is applied to the issue of tobacco control in the state of California, suggesting policy solutions and strategies to achieve their placement on the policy agenda. Strategies and techniques that may be useful to nurse policy champions are elucidated.

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Tobacco treatment services should be covered under Medicaid

Cited by 23 publications

References 2 publications

Boosting Population Quits Through Evidence-Based Cessation Treatment and Policy

Boosting Population Quits Through Evidence-Based Cessation Treatment and Policy

Examining the effects of tobacco treatment policies on smoking rates and smoking related deaths using theSimSmokecomputer simulation model

Putting Policy Theory to Work: Tobacco Control in California

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