Medicaid coverage for tobacco dependence treatments in Massachusetts and associated decreases in smoking prevalence.
Approximately 50% of smokers die prematurely from tobacco-related diseases. In July 2006, the Massachusetts health care reform law mandated tobacco cessation coverage for the Massachusetts Medicaid population. The new benefit included behavioral counseling and all medications approved for tobacco ce...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2010-03-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC2841201?pdf=render |
| _version_ | 1817995601298587648 |
|---|---|
| author | Thomas Land Donna Warner Mark Paskowsky Ayesha Cammaerts LeAnn Wetherell Rachel Kaufmann Lei Zhang Ann Malarcher Terry Pechacek Lois Keithly |
| author_facet | Thomas Land Donna Warner Mark Paskowsky Ayesha Cammaerts LeAnn Wetherell Rachel Kaufmann Lei Zhang Ann Malarcher Terry Pechacek Lois Keithly |
| author_sort | Thomas Land |
| collection | DOAJ |
| description | Approximately 50% of smokers die prematurely from tobacco-related diseases. In July 2006, the Massachusetts health care reform law mandated tobacco cessation coverage for the Massachusetts Medicaid population. The new benefit included behavioral counseling and all medications approved for tobacco cessation treatment by the U.S. Food and Drug Administration (FDA). Between July 1, 2006 and December 31, 2008, a total of 70,140 unique Massachusetts Medicaid subscribers used the newly available benefit, which is approximately 37% of all Massachusetts Medicaid smokers. Given the high utilization rate, the objective of this study is to determine if smoking prevalence decreased significantly after the initiation of tobacco cessation coverage.Smoking prevalence was evaluated pre- to post-benefit using 1999 through 2008 data from the Massachusetts Behavioral Risk Factor Survey (BRFSS). The crude smoking rate decreased from 38.3% (95% C.I. 33.6%-42.9%) in the pre-benefit period compared to 28.3% (95% C.I.: 24.0%-32.7%) in the post-benefit period, representing a decline of 26 percent. A demographically adjusted smoking rate showed a similar decrease in the post-benefit period. Trend analyses reflected prevalence decreases that accrued over time. Specifically, a joinpoint analysis of smoking prevalence among Massachusetts Medicaid benefit-eligible members (age 18-64) from 1999 through 2008 found a decreasing trend that was coincident with the implementation of the benefit. Finally, a logistic regression that controlled for demographic factors also showed that the trend in smoking decreased significantly from July 1, 2006 to December 31, 2008.These findings suggest that a tobacco cessation benefit that includes coverage for medications and behavioral treatments, has few barriers to access, and involves broad promotion can significantly reduce smoking prevalence. |
| first_indexed | 2024-04-14T02:09:51Z |
| format | Article |
| id | doaj.art-fbcb866046004f0f8bef55c5e6e1d886 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-14T02:09:51Z |
| publishDate | 2010-03-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-fbcb866046004f0f8bef55c5e6e1d8862022-12-22T02:18:33ZengPublic Library of Science (PLoS)PLoS ONE1932-62032010-03-0153e977010.1371/journal.pone.0009770Medicaid coverage for tobacco dependence treatments in Massachusetts and associated decreases in smoking prevalence.Thomas LandDonna WarnerMark PaskowskyAyesha CammaertsLeAnn WetherellRachel KaufmannLei ZhangAnn MalarcherTerry PechacekLois KeithlyApproximately 50% of smokers die prematurely from tobacco-related diseases. In July 2006, the Massachusetts health care reform law mandated tobacco cessation coverage for the Massachusetts Medicaid population. The new benefit included behavioral counseling and all medications approved for tobacco cessation treatment by the U.S. Food and Drug Administration (FDA). Between July 1, 2006 and December 31, 2008, a total of 70,140 unique Massachusetts Medicaid subscribers used the newly available benefit, which is approximately 37% of all Massachusetts Medicaid smokers. Given the high utilization rate, the objective of this study is to determine if smoking prevalence decreased significantly after the initiation of tobacco cessation coverage.Smoking prevalence was evaluated pre- to post-benefit using 1999 through 2008 data from the Massachusetts Behavioral Risk Factor Survey (BRFSS). The crude smoking rate decreased from 38.3% (95% C.I. 33.6%-42.9%) in the pre-benefit period compared to 28.3% (95% C.I.: 24.0%-32.7%) in the post-benefit period, representing a decline of 26 percent. A demographically adjusted smoking rate showed a similar decrease in the post-benefit period. Trend analyses reflected prevalence decreases that accrued over time. Specifically, a joinpoint analysis of smoking prevalence among Massachusetts Medicaid benefit-eligible members (age 18-64) from 1999 through 2008 found a decreasing trend that was coincident with the implementation of the benefit. Finally, a logistic regression that controlled for demographic factors also showed that the trend in smoking decreased significantly from July 1, 2006 to December 31, 2008.These findings suggest that a tobacco cessation benefit that includes coverage for medications and behavioral treatments, has few barriers to access, and involves broad promotion can significantly reduce smoking prevalence.http://europepmc.org/articles/PMC2841201?pdf=render |
| spellingShingle | Thomas Land Donna Warner Mark Paskowsky Ayesha Cammaerts LeAnn Wetherell Rachel Kaufmann Lei Zhang Ann Malarcher Terry Pechacek Lois Keithly Medicaid coverage for tobacco dependence treatments in Massachusetts and associated decreases in smoking prevalence. PLoS ONE |
| title | Medicaid coverage for tobacco dependence treatments in Massachusetts and associated decreases in smoking prevalence. |
| title_full | Medicaid coverage for tobacco dependence treatments in Massachusetts and associated decreases in smoking prevalence. |
| title_fullStr | Medicaid coverage for tobacco dependence treatments in Massachusetts and associated decreases in smoking prevalence. |
| title_full_unstemmed | Medicaid coverage for tobacco dependence treatments in Massachusetts and associated decreases in smoking prevalence. |
| title_short | Medicaid coverage for tobacco dependence treatments in Massachusetts and associated decreases in smoking prevalence. |
| title_sort | medicaid coverage for tobacco dependence treatments in massachusetts and associated decreases in smoking prevalence |
| url | http://europepmc.org/articles/PMC2841201?pdf=render |
| work_keys_str_mv | AT thomasland medicaidcoveragefortobaccodependencetreatmentsinmassachusettsandassociateddecreasesinsmokingprevalence AT donnawarner medicaidcoveragefortobaccodependencetreatmentsinmassachusettsandassociateddecreasesinsmokingprevalence AT markpaskowsky medicaidcoveragefortobaccodependencetreatmentsinmassachusettsandassociateddecreasesinsmokingprevalence AT ayeshacammaerts medicaidcoveragefortobaccodependencetreatmentsinmassachusettsandassociateddecreasesinsmokingprevalence AT leannwetherell medicaidcoveragefortobaccodependencetreatmentsinmassachusettsandassociateddecreasesinsmokingprevalence AT rachelkaufmann medicaidcoveragefortobaccodependencetreatmentsinmassachusettsandassociateddecreasesinsmokingprevalence AT leizhang medicaidcoveragefortobaccodependencetreatmentsinmassachusettsandassociateddecreasesinsmokingprevalence AT annmalarcher medicaidcoveragefortobaccodependencetreatmentsinmassachusettsandassociateddecreasesinsmokingprevalence AT terrypechacek medicaidcoveragefortobaccodependencetreatmentsinmassachusettsandassociateddecreasesinsmokingprevalence AT loiskeithly medicaidcoveragefortobaccodependencetreatmentsinmassachusettsandassociateddecreasesinsmokingprevalence |