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September 8, 2000
CDC, Office on Smoking and Health
(770) 4885493

Fact Sheet: Advice to Quit Smoking in Medicare Managed Care

Older smokers are at greater risk for smoking-related disease such as cardiovascular disease, stroke, cancer, and respiratory disease.

  • In 1998, the prevalence of daily cigarette smoking was 36.7% among Medicare managed care enrollees aged 55-64, 15.1% among persons aged 65-74, 9.1% among persons aged 75-84, and 4.5% among persons aged 85 and older.
  • Medicare managed care enrollees are more likely to visit a physician or healthcare provider than other smokers; however, only 71% of older smokers receive advice to quit smoking.
  • For those enrolled in a Medicare managed care plan, who reported any smoking in the past 12 months, the advice to quit increased with the number of visits to physicians or healthcare providers. An estimated 61.5% who made at least one visit in the past 12 months reported receiving advice to quit, while 76.2% who made five or more visits received advice to quit.
  • African Americans (67.8%) and Hispanics (65.4%), who are enrolled in the Medicare managed care plan were less likely to receive advice to quit compared with older whites (72.2 %). However, Asian Pacific Islanders (54%) reported receiving less advice than all racial/ethnic groups on Medicare. For both Hispanic and Asian Americans, language barriers may play an important role in the lower rates of receiving advice to quit from physicians and healthcare providers.
  • Smokers aged 75 and older, who are enrolled in a Medicare managed care plan, were less likely to receive advice to quit smoking than younger smokers despite the health benefits they would experience if they quit. Older adults smokers with a household income of less than $10,000 were less likely to receive advice to quit.
  • Tobacco-use treatment guidelines published by the Public Health Service provides a blueprint for healthcare professionals and health insurance providers in implementing appropriate medical services that will help treat nicotine addiction. The recently released "Reducing Tobacco Use: A Report of the Surgeon General," (http://www.osophs.dhhs.gov/library/tobacco_use/) provides further evidence that physicians advising their patients to quit smoking, can produce cessation rates of 5% to 10% per year. Combining behavioral counseling and pharmacologic treatment can produce quit rates of 20-25% in one year.
  • Increasing delivery of smoking cessation advice to 90% of Medicare recipients, who still smoke, could encourage an additional 25,000 smokers to quit each year.
  • Behavior change such as smoking cessation, even late in life, reduces mortality and can result in improved and enhanced quality of life for older smokers.

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