Partnership for Prevention awarded six ActionToQuit state grants in 2010 for the implementation of innovative strategies to advance to tobacco cessation, with funds used for the development of state alliances/summit meetings and the creation of strategic plans. The projects will involve various sectors that can impact access to tobacco cessation including employers, health care systems, insurers, quitlines, and policymakers. The state grant projects are:
- Colorado - Cessation Coverage/Treatment for Colorado's Uninsured
- Florida - Tobacco Cessation Summit & Action Plan
- Nevada - Increasing Cessation Access for All Nevadans
- New England - New England Partnership for Smoking Cessation Policy
- New York - New York State Access to Tobacco Use Treatment Strategic Planning Project
- Virginia - Virginia Partnership for Tobacco Use Cessation
A brief on each grantee's initiative has been posted to the ActionToQuit website.
2. Your website offers some valuable resources for those interested in expanding access to tobacco cessation treatment. Could you tell us about the recent creation of Saving Lives and Money - Helping People on Medicaid Quit Tobacco? What was the history behind the creation of the guide?
Saving Lives and Money - Helping People on Medicaid Quit Tobacco is a new resource from Partnership and the American Lung Association. It's the second guide of its kind from these national partners, the first one dealing with state employee tobacco cessation coverage. This resource is important because of the high rates of tobacco use among the Medicaid population and the associated costs. The big idea is that because so much of Medicaid's funding goes toward tobacco-related diseases, an up-front investment in prevention (i.e. tobacco cessation) must be given serious consideration. In 2004, U.S. Medicaid expenditures for illnesses caused by tobacco totaled $30 billion, or 11% of the entire Medicaid budget. The point is that we must do more to help people on Medicaid quit tobacco - if we do we'll save both lives and money.
3. Why did you feel there is a need for such a resource?
ActionToQuit wants to spotlight the states that are doing the best job at providing Medicaid coverage for their tobacco users. The six states that lead the way by covering all treatments recommended by the U.S. Public Health Service are Indiana, Massachusetts, Minnesota, Nevada, Oregon, and Pennsylvania. In particular, we applaud their efforts to cover all medications and counseling treatments since most smokers will need many attempts and (possibly) several different tools to quit successfully.
4. What audience is the guide intended for?
Partnership for Prevention believes that all Medicaid plans should be required to cover all cessation treatments. To this end the new guide is intended for advocates that comprise state tobacco control coalitions, insurers/health plans, state Medicaid leaders, and policymakers. States have achieved many outstanding advances in smoke free air laws and increased tobacco taxes and these accomplishments are to be commended. However, tobacco control policies related to cessation have often lagged behind. One area in which much progress is needed involves the unnecessary barriers that exist which make it harder for people to make quit attempts. Insurers and policymakers should focus on removing these barriers, which include co-pays, duration limits, annual limits on quit attempts, and dollar limits. There are policy solutions for these problems.
5. How does the guide address the passage of health reform for Medicaid and cessation coverage? For example: I understand the new health reform bill requires that all state Medicaid programs provide comprehensive tobacco cessation care to pregnant women. What are some of the recommendations in the guide for state Medicaid programs to implement these changes?
The passage of health reform will do much to advance tobacco cessation in the United States. Shortly, private health plans will be required to extend coverage of many clinical prevention services recommended by the U.S. Preventive Services Task Force. This coverage will include tobacco cessation interventions. All state Medicaid plans will be required to provide tobacco cessation coverage for pregnant women, but to them only. Partnership for Prevention and other national partners believe that this is the right time for states to voluntarily extend tobacco cessation coverage to all Medicaid beneficiaries, not just pregnant women. The six states I mentioned have done this because it made sense from the health promotion and fiscal angles. When people quit smoking successfully, they realize many health benefits. But states can benefit too.
6. Action to Quit has many cessation resources and partnership activities listed on the website. Are there specific resources Partnership offers around implementing tobacco free policy changes which you can share with our audience?
Three guides, all available for free download on www.actiontoquit.org, come to mind. "Smoke-Free Policies - An Action Guide" is a resource for workplaces and community leaders that want to establish ordinances to protect the public from secondhand smoke. It translates the evidence-based recommendations in "The Community Guide" into implementation strategies. "Investing in a Tobacco-Free Future" is a tool kit for the workplace. It outlines the costs of smoking to businesses, the impact on worker productivity, and how to implement tobacco use treatment policies through a health plan. "Investing in Health - Proven Health Promotion Practices for Workplaces" charts a course for businesses to implement three inexpensive strategies to save lives from tobacco. They are: implementing tobacco-free policies, offering tobacco use treatment benefits, and providing access to a telephone quitline for tobacco users.
7. What other tools and resources can people anticipate in the future?
Partnership for Prevention recently extended funding to the Joint Commission to develop and test a global set of tobacco cessation quality standards which would be applicable to all hospitalized patients. If adopted, these measures will require hospitals to identify all patients who use tobacco and offer them counseling, medications and limited follow-up. Later in 2010, when the final standards are published, Partnership will create and disseminate an implementation guide for hospitals. Additionally, Partnership will produce case studies for each of our funded ActionToQuit grantee states. These will describe their journey in forming a state tobacco cessation alliance, holding a summit meeting, and creating a state action plan to advance cessation.
8. What recommendations do you have for those interested in creating their own partnership around cessation or improving one that already exists?
Two things have been proven in the past decade:
- First, the highly successful tobacco tax and smoke-free state campaigns have proven that tobacco control advocates can come together and, through a strong synergistic effort, change policies and save lives. It's happened across the country.
- Second, we've learned just recently that a state can cover all its Medicaid subscribers for tobacco cessation treatment and see positive short term results. Massachusetts implemented a comprehensive tobacco cessation benefit in July of 2006 and has seen smoking rates for beneficiaries in its Medicaid program drop 26% in two and a half years.
The Action to Quit Network is a group of over 500 professionals who are committed to tobacco cessation. For more information contact: Brandi Robinson at
[email protected], 202-384-1505 or David Zauche at [email protected], 202-375-7807.
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SAMHSA continues its commitment to address nicotine addiction
The Substance Abuse and Mental Health Services Administration and the Smoking Cessation Leadership Center have launched Phase II of the SAMHSA 100 Pioneers for Smoking Cessation campaign. Demonstrating SAMHSA's ongoing commitment to provide smoking cessation services to behavioral health clients and staff, 25 of the original SAMHSA 100 Pioneers have been selected to receive an honorarium and continue their efforts to integrate smoking cessation services into current treatment programs.
Despite impressive declines in the general smoking rate (now at 19%), people with behavioral health issues continue to smoke at alarmingly high rates and are suffering severe consequences. "Tobacco use remains the single most preventable cause of death -- causing about 440,000 deaths per year in the United States and almost half of these deaths are people with mental health and substance use disorders." says Dr. Steven A Schroeder, director of the Smoking Cessation Leadership Center. "Nicotine addiction negatively impacts treatment outcomes for people in recovery. We must continue to work together to increase access to smoking cessation services for individuals with mental and substance use disorders
To assist SAMHSA grantees in promoting smoking cessation, SAMHSA will continue its partnership with the Smoking Cessation Leadership Center at the University of California.
Through this partnership, Pioneers have access to free technical assistance and resource materials provided by the Smoking Cessation Leadership Center. Webinars, training guides and other materials are being customized to address the unique needs of the behavioral health population.
"These agencies have made huge strides towards helping their clients live longer healthier lives," says Doug Tipperman, Acting Branch Chief in SAMHSA's Center for Substance Abuse Prevention. "Many are taking steps to go smoke-free even if there is no state mandate, while others have already gone smoke-free and are working to sustain the new policy change. They are true pioneers for smoking cessation and are paving the way for others to come."
For the full list of Pioneers and more information on the Pioneers campaign visit http://smokingcessationleadership/Pioneers.htm.
