Does State Medicaid Coverage of Smoking Cessation Treatments Affect Quitting?

Health Serv Res. 2018 Dec;53(6):4725-4746. doi: 10.1111/1475-6773.12979. Epub 2018 May 27.

Abstract

Objective: Cigarette smoking and smoking-related diseases disproportionately affect low-income populations. Health insurance coverage of smoking cessation treatments is increasingly used to encourage quitting. We assess the relationship between state Medicaid coverage of smoking cessation treatments and past-year quitting in adult Medicaid beneficiaries.

Data sources: 2009-2014 National Health Interview Survey (NHIS); 2008-2013 indicators of state Medicaid coverage of smoking cessation treatments.

Study design: A triple-differencing specification based on differences in Medicaid cessation coverage policies across states as well as within-state differences between Medicaid beneficiaries and a counterfactual group of low-income adults not covered by Medicaid.

Data collection/extraction methods: Individual-level NHIS data with restricted geographical identifiers were merged with state-year Medicaid coverage indicators.

Principal findings: Combined coverage of both cessation counseling and medications in state Medicaid programs was associated with increased quitting, with an estimated mean increase in past-year quitting of 3.0 percentage points in covered Medicaid beneficiaries relative to persons without coverage.

Conclusions: Combined coverage of both smoking cessation counseling and medication by state Medicaid programs could help reduce cigarette smoking among Medicaid beneficiaries.

Keywords: Smoking; state health policies; tobacco-dependence treatments.

MeSH terms

  • Counseling
  • Health Behavior
  • Health Services Accessibility / statistics & numerical data
  • Health Surveys
  • Humans
  • Insurance Coverage / economics
  • Insurance Coverage / statistics & numerical data*
  • Medicaid / economics
  • Medicaid / statistics & numerical data*
  • Poverty
  • Smoking Cessation / economics
  • Smoking Cessation / statistics & numerical data*
  • Tobacco Use Cessation / economics
  • Tobacco Use Cessation / methods*
  • Tobacco Use Disorder / drug therapy
  • United States