IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0009770.html
   My bibliography  Save this article

Medicaid Coverage for Tobacco Dependence Treatments in Massachusetts and Associated Decreases in Smoking Prevalence

Author

Listed:
  • Thomas Land
  • Donna Warner
  • Mark Paskowsky
  • Ayesha Cammaerts
  • LeAnn Wetherell
  • Rachel Kaufmann
  • Lei Zhang
  • Ann Malarcher
  • Terry Pechacek
  • Lois Keithly

Abstract

Background: Approximately 50% of smokers die prematurely from tobacco-related diseases. In July 2006, the Massachusetts health care reform law mandated tobacco cessation coverage for the Massachusetts Medicaid population. The new benefit included behavioral counseling and all medications approved for tobacco cessation treatment by the U.S. Food and Drug Administration (FDA). Between July 1, 2006 and December 31, 2008, a total of 70,140 unique Massachusetts Medicaid subscribers used the newly available benefit, which is approximately 37% of all Massachusetts Medicaid smokers. Given the high utilization rate, the objective of this study is to determine if smoking prevalence decreased significantly after the initiation of tobacco cessation coverage. Methods and Findings: Smoking prevalence was evaluated pre- to post-benefit using 1999 through 2008 data from the Massachusetts Behavioral Risk Factor Survey (BRFSS). The crude smoking rate decreased from 38.3% (95% C.I. 33.6%–42.9%) in the pre-benefit period compared to 28.3% (95% C.I.: 24.0%–32.7%) in the post-benefit period, representing a decline of 26 percent. A demographically adjusted smoking rate showed a similar decrease in the post-benefit period. Trend analyses reflected prevalence decreases that accrued over time. Specifically, a joinpoint analysis of smoking prevalence among Massachusetts Medicaid benefit-eligible members (age 18–64) from 1999 through 2008 found a decreasing trend that was coincident with the implementation of the benefit. Finally, a logistic regression that controlled for demographic factors also showed that the trend in smoking decreased significantly from July 1, 2006 to December 31, 2008. Conclusion: These findings suggest that a tobacco cessation benefit that includes coverage for medications and behavioral treatments, has few barriers to access, and involves broad promotion can significantly reduce smoking prevalence.

Suggested Citation

  • Thomas Land & Donna Warner & Mark Paskowsky & Ayesha Cammaerts & LeAnn Wetherell & Rachel Kaufmann & Lei Zhang & Ann Malarcher & Terry Pechacek & Lois Keithly, 2010. "Medicaid Coverage for Tobacco Dependence Treatments in Massachusetts and Associated Decreases in Smoking Prevalence," PLOS ONE, Public Library of Science, vol. 5(3), pages 1-6, March.
  • Handle: RePEc:plo:pone00:0009770
    DOI: 10.1371/journal.pone.0009770
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0009770
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0009770&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0009770?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Lei, Lianlian & Liu, Feng, 2021. "Medicaid coverage and use of nicotine replacement treatment," Economics & Human Biology, Elsevier, vol. 40(C).
    2. Miraldo, Marisa & Propper, Carol & Williams, Rachael I., 2018. "The impact of publicly subsidised health insurance on access, behavioural risk factors and disease management," Social Science & Medicine, Elsevier, vol. 217(C), pages 135-151.
    3. Patrick Richard & Kristina West & Leighton Ku, 2012. "The Return on Investment of a Medicaid Tobacco Cessation Program in Massachusetts," PLOS ONE, Public Library of Science, vol. 7(1), pages 1-8, January.
    4. Jennifer Kahende & Ann Malarcher & Lucinda England & Lei Zhang & Paul Mowery & Xin Xu & Varadan Sevilimedu & Italia Rolle, 2017. "Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999–2008," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-15, February.
    5. Michael R. Richards & Joachim Marti & Johanna Catherine Maclean & Jason Fletcher & Donald Kenkel, 2017. "Tobacco Control, Medicaid Coverage, and the Demand for Smoking Cessation Drugs," American Journal of Health Economics, University of Chicago Press, vol. 3(4), pages 528-549, Fall.
    6. Shu-Hong Zhu & Christopher M Anderson & Yue-Lin Zhuang & Anthony C Gamst & Neal D Kohatsu, 2017. "Smoking prevalence in Medicaid has been declining at a negligible rate," PLOS ONE, Public Library of Science, vol. 12(5), pages 1-15, May.
    7. James Nonnemaker & James Hersey & Ghada Homsi & Andrew Busey & Andrew Hyland & Harlan Juster & Matthew Farrelly, 2011. "Self-Reported Exposure to Policy and Environmental Influences on Smoking Cessation and Relapse: A 2-Year Longitudinal Population-based Study," IJERPH, MDPI, vol. 8(9), pages 1-18, September.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0009770. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.