What Is the Role of Health Insurance Coverage in Tobacco Use Cessation?

 

 

• Health insurance coverage of medication and counseling increases the use of effective treatments.¹⁸
• Although 66% of Americans under the age of 65 are insured through an employer,²²only 24% of employers offer any coverage for tobacco-use treatment.²³

How Much Do Cessation Benefits Cost? Are They Cost Effective?

• Tobacco cessation is more cost-effective than other common and covered disease prevention interventions, such as the treatment of hypertension and high blood cholesterol.¹⁴
• Cost analyses have shown tobacco cessation benefits to be either cost–saving or cost–neutral.^{3, 20} Overall, cost/expenditure to employers equalizes at 3 years; benefits exceed costs by 5 years.³
• It costs between 10 and 40 cents per member per month to provide a comprehensive tobacco cessation benefit (costs vary based on utilization and dependent coverage).^19,24
• In contrast, the annual cost of tobacco use is about $3,400 per smoker or about $7.18 for each pack of cigarettes sold.⁴
• Neonatal health care costs related to smoking are equivalent to $704 for each maternal smoker.⁴ Randomized controlled trials indicate that a smoking cessation program for pregnant women can save as much as $6 for each $1 spent.²⁵

What Is the Experience of Companies and Health Plans Providing This Benefit?

Businesses that have included a tobacco cessation benefit report that this coverage has increased the number of smokers willing to undergo treatment and increased the percentage that successfully quit.^{24, 26}

How Tobacco Cessation Cuts Cost

Union Pacific Railroad has experienced a decrease smoking prevalence among its employees from 40% to 25% in the 7-year period that it has offered a cessation benefit as part of a comprehensive cessation program. 26 At the Group Health Cooperative in Seattle, enrollees offered full coverage for smoking cessation treatments were four times as likely to try to quit and four times as likely to succeed.24

Over time, tobacco-use cessation benefits generate financial returns for employers in four ways: Reduced health care costs 3, 27 Reduced absenteeism 3, 28, 29 Increased on–the–job productivity 3, 28, 29 Reduced life insurance costs 3, 28 Benefits realized more immediately include: Increases in employee productivity 3, 29 Reductions in smoking–attributed neonatal health care costs 25 Employers who provide a smoke-free workplace may also realize savings on fire insurance and costs related to items such as ventilation services and property repair and upkeep. 3, 28

How Do I Get More Information?

Listed below are Web sites where you can find additional information on tobacco-use cessation or reimbursement for cessation treatment.

Smoking Cessation Treatment Effectiveness

• Treating Tobacco Use and Dependence is a Public Health Service-sponsored clinical practice guideline that contains evidence-based strategies and recommendations to support effective treatment for tobacco use and nicotine addiction. The guideline and related consumer and clinician materials also can be found at http://www.surgeongeneral.gov/tobacco/.
• The Guide to Community Preventive Services provides information on the effectiveness of community-based interventions in three areas of tobacco-use prevention and control: (1) initiation of tobacco use, (2) cessation, and (3) reduction of exposure to environmental tobacco smoke. Articles, slide sets, and commentaries can be found at http://www.thecommunityguide.org/tobacco/.
• Surgeon General's Reports related to tobacco are available on the Centers for Disease Control and Prevention Web site at http://www.cdc.gov/tobacco/data_statistics/sgr/index.htm.
• Data on tobacco-use prevalence and tobacco-related morbidity and mortality rates can be found at two CDC Web sites: Smoking & Tobacco Use at http://www.cdc.gov/tobacco/data_statistics/ and National Center for Health Statistics at http://www.cdc.gov/nchs/.