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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

Coverage of tobacco-use cessation treatment increases both use of effective treatment and the number of successful quit attempts.18

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 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.
  • Surgeon General's Reports related to tobacco are available on the Centers for Disease Control and Prevention Smoking & Tobacco Use Web site.
  • Data on tobacco-use prevalence and tobacco-related morbidity and mortality rates can be found at two CDC Web sites: Smoking & Tobacco Use and National Center for Health Statistics.
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