November 20, 2009

During the past month, smoking cessation research has been a major of discussion point among those in the tobacco control community and in the media. Several organizations have released updates on research and recommendations, and below are the summaries of these tobacco cessation news items.

ALA: Helping Smokers Quit: State Cessation Coverage 2009

As the debate over health care reform dominates the media and political arena, a new American Lung Association (ALA) report finds that states are not doing enough to help smokers quit – and policymakers must fix this in the health care reform process. The Helping Smokers Quit: State Cessation Coverage 2009 report provides an overview of smoking cessation services and treatments offered in each state by public and private health care plans. Currently, only six states provide comprehensive smoking cessation coverage for Medicaid recipients, and only five states provide such coverage to state employees. The ALA calls upon each state to provide all Medicaid recipients, state employees and private insurance holders with comprehensive, easily-accessible tobacco cessation medications and counseling. The Helping Smokers Quit: State Cessation Coverage 2009 report can be found by visiting www.lungusa.org.

MMWR:  State Medicaid Coverage for Tobacco-Dependence Treatments

The November 6^th issue of the Morbidity and Mortality Weekly Report included an article, titled “State Medicaid Coverage for Tobacco-Dependence Treatments, United States” (2007), which summarized the coverage level among state Medicaid plans for tobacco-dependence treatments. The study – which cites the Call for ACTTION as a report recommending comprehensive coverage for tobacco-dependence treatments without barriers – surveyed the nation’s Medicaid programs in 2007 in order to track the progress toward reaching the Health People 2010 goal of “expanding coverage of evidence-based treatments for nicotine dependency to all 51 Medicaid programs.” The study shows that the number of Medicaid fee-for-service programs covering effective tobacco-dependence treatments has increased over time—from 23 programs in 1998 to 43 in 2007—but that Medicaid still falls short of national goals for overall coverage of pharmacotherapy and counseling. The full article can be found at:  http://www.cdc.gov/mmWR/preview/mmwrhtml/mm5843a1.htm.

MMWR:  Cigarette Smoking Among Adults…Has the Downward Trend Come to an End?

The November 13^th issue of the Morbidity and Mortality Weekly Report included an article, titled “Cigarette Smoking Among Adults and Trends in Smoking Cessation – United States” (2008), showing that 20.6 percent of U.S. adults aged 18 and over (or about 46 million people) were smokers in 2008, up slightly from 19.8 percent in 2007. Like the Medicaid article published the week before, this too was an assessment of the progress made toward reaching the Healthy People 2010 objective of “reducing the prevalence of cigarette smoking among adults to less than 12 percent.” While it is important to note that the latest data does not reflect the impact of the federal cigarette tax implemented in April, nor the new Food and Drug Administration oversight over tobacco products, this report highlights the fact that although the United States has made great strides toward reducing the prevalence of smoking, we have a long way to go. The full article can be found at:  http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5844a2.htm.

Update on Treating Tobacco Use and Dependence

Last month, Dr. Michael Fiore of the Center for Tobacco Research and Intervention at the University of Wisconsin School of Medicine and Public Health, provided an 18-month update on the U.S. Public Health Service Clinical Practice Guideline, Treating Tobacco Use and Dependence, released on May 7, 2008. He reported several new tools have been developed and are now available online, including:

§  A 20-page “quick reference guide” for clinicians that summarizes key guideline findings

§  PowerPoint slides with data tables and recommendations from the guideline to aid policymakers, researchers and others who may need this information for presentations

§  A 30-40 minute PowerPoint presentation that summarizes key findings in the 2008 guideline for people who wish to give a presentation on the guideline.

§  A tool summarizing key strategies and opportunities for health systems that are interested in incorporating the guideline recommendations into clinical practice

§  An updated poster for clinician offices

§  A new Guideline addition and corrections section. This new section now provides clinicians with a link to the recent update by the FDA on the use of bupropion and varenicline, and a correction to Table 6.22 from page 102

These new tools and other materials, including the full Guideline and references, are available online at: http://www.ahrq.gov/path/tobacco.htm#Clinic and http://www.surgeongeneral.gov/tobacco/.