States fail to cover smoking cessation treatment for employees

Despite recommendations from federal public health experts that smoking cessation treatment should be provided to all smokers, state employers are failing to provide their employees with recommended smoking cessation treatment coverage, according to a study published in this month’s American Journal of Public Health.

According to a study of insurance coverage provided to the nation’s five million state employees, only 29 of 45 states surveyed required that any smoking cessation treatment be included in their insurance coverage for state employees. And a mere 17 of the 45 states provided the complete range of smoking cessation coverage recommended by the U. S. Public Health Service to any of their employees.

“What this research shows is that most state employers are missing an opportunity to reduce smoking rates among their employees by not providing coverage of the full range of smoking cessation treatment such as medication and counseling,” says Marguerite Burns, the study’s lead author.

Researchers from the University of Wisconsin Transdisciplinary Tobacco Use Research Center found that only seven states required smoking cessation treatment coverage that was fully consistent with recommendations in the U.S. Public Health Service Clinical Practice Guideline for all state employees. This means they required coverage for counseling and one or more of the FDA-approved medications for smoking cessation treatment. An additional ten states required this coverage for at least some of their state employees. A surprising 16 states did not require coverage of treatment for any state employees.

These results echo those of previous studies in other populations. The provision of insurance coverage for smoking cessation treatment remains spotty. In many cases, only some employees are covered and/or they are covered for only some treatments.

Although research findings concerning the effects of insurance coverage are not conclusive, insurance coverage for smoking cessation treatment holds promise as a means of reducing smoking rates in insured populations.

“In many markets, states and other public employers serve as leaders influencing insurance coverage,” Burns says. “Unfortunately, many are not rising to the occasion as models for healthcare purchasers in terms of covering smoking cessation treatment.”

Forty-five of 50 states participated in the study, which was conducted between September 2002 and February 2003. The seventeen states that provide the recommended coverage to their employees were: Alabama, Arkansas, California, Indiana, Maine, Missouri, North Carolina, New Jersey, New Mexico, Oklahoma, South Dakota, Tennessee, Virginia, Vermont, Washington, Wisconsin and West Virginia.

This study was supported by a grant from the Robert Wood Johnson Foundation through its Partners with Tobacco Use Research Centers program. The Robert Wood Johnson Foundation was established as a national philanthropy in 1972 and today it is the largest U.S. foundation devoted to improving the health and health care of all Americans.