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Coverage For Tobacco Use Cessation Treatments
Full Report in Adobe Acrobat
Format (
PDF-152K)
Why Is Health Insurance Coverage for Tobacco Use Treatments So Important?
- Smoking is costly to employers both in terms of smoking-related medical expenses and lost productivity.
- Ten percent of smokers alive today are living with a smoking-related illness.1
- Men who smoke incur $15,8002 (in 2002 dollars) more in lifetime medical expenses and are absent from work 4 days more per year than men who do not smoke.3
- Women who smoke incur $17,5002 (in 2002 dollars) more in lifetime medical expenses and are absent from work 2 days more each year than nonsmoking women.3
- In 1999, each adult smoker cost employers $1,760 in lost productivity and $1,623 in excess medical expenditures.4
- Smoking causes heart disease, stroke, multiple cancers, respiratory diseases, and other costly illnesses. Secondhand smoke causes lung disease and lung cancer.5, 6
- Smoking increases costly complications of pregnancy, such as pre-term delivery and low birth-weight infants.7
- Smoking is the leading preventable cause of death in the United States.8,9 Smokers who quit will, on average, live longer and have fewer years living with disability.10
- About 23% of American adults and 28% of teens smoke.11,12 More than 70% want to quit, but few succeed without help.11 Tobacco use treatment doubles quitting success rates.9
Paying for tobacco use cessation treatments is the single most cost-effective health insurance benefit for adults that can be provided to employees.13,14,15
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What Treatments Are Available? How Effective Are They?
Smoking cessation treatments have been found to be safe and effective.
These include counseling and medications, or a combination of both.9
- Face-to-face counseling and interactive telephone counseling are more effective than services that only provide educational or self-help materials.
9,
16
- The effectiveness of counseling services increases as their intensity (the number and length of sessions) increases.9
- Smokers are more likely to use telephone counseling than to participate in individual or group counseling sessions.16,
17
- The Food and Drug Administration has approved six first-line medications to help smokers quit:
- Five are nicotine replacement therapies that relieve withdrawal symptoms. They include nicotine gum, patch, nasal spray, inhaler, and lozenge.9
- The sixth medication, bupropion SR (sustained release), is a non-nicotine medication that is thought to reduce the urge to smoke by affecting the same chemical messengers in the brain that are affected by nicotine.9
Prescription and Over-the-Counter Tobacco Cessation Medications*
Type |
Form |
Common Brand Name(s) |
Availability |
Nicotine Replacement Therapy |
Gum |
Nicorette® |
Over-the-counter (OTC) |
Patch |
Nicoderm®, Habitrol®, Prostep®, Nicotrol® |
OTC and prescription |
Inhaler |
Nicotrol® |
Prescription |
Nasal Spray |
Nicotrolฎ |
Prescription |
Lozenge |
Commit®** |
OTC |
Bupropion SR |
Pill |
Zyban®, Wellbutrin® |
Prescription |
* Approved by the Food and Drug Administration (FDA) and addressed in the 2000 PHS Guidelines.
** Received FDA approval on October 31, 2002, therefore not addressed in the 2000 PHS Guidelines.
Scientifically proven treatments can double a person's chances of quitting smoking.9
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Top
How Should Benefits Be
Designed?
Benefits for proven tobacco-use cessation treatments have been shown to increase treatment use and the number of successful quitters; therefore, both the Public Health Service-sponsored Clinical Practice Guideline, Treating Tobacco Use and Dependence, and the Community Preventive Services Task Force recommend that all insurers provide tobacco cessation benefits that do the following:
- Cover at least four counseling sessions of at least 30 minutes each,9 including proactive telephone counseling and individual counseling. While classes are also effective, few smokers attend them.19
- Ten percent of smokers alive today are living with a smoking-related illness.1
- Cover both prescription and over-the-counter nicotine replacement medication and bupropion (see medication table).9
- Provide counseling and medication coverage for at least two smoking cessation attempts per year.20,21
- Eliminate or minimize co-pays or deductibles for counseling and medications, as even small copayments reduce the use of proven treatments.18,19
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