1. Enhancing Tobacco Cessation Treatment for the Medicaid Population Linda Bailey, Center for Tobacco Cessation Helen Halpin, University of California at Berkeley Matt Barry, Campaign for Tobacco Free Kids Dianne Barker, National Partnership to Help Pregnant Smokers Quit Thursday, December 11, 2003 10:30 a.m. to Noon Sheraton Boston – Fairfax A

2. Purpose of the Session 1.Overview of tobacco cessation 2.Update on cessation services offered by state Medicaid programs 3.Legislative activity to enhance Medicaid coverage 4.Toolkits and resources for education and advocacy 5.Discussion with audience

3. Importance of Focusing on Cessation and Medicaid Toll of premature mortality and costs of tobacco related disease Availability of effective tobacco cessation treatments and activities Extremely high prevalence of tobacco among Medicaid population Opportunity to enhance coverage and reimbursement for Medicaid Importance of reaching Healthy People 2010 objective of 12% prevalence

4. Cessation Facts (2001 data) 46.2 Million current adult smokers (22.8 percent) 44.7 Million former smokers 70% of smokers report “wanting to quit” 41% percent attempt to quit Less than 20% use “cessation aid” in their quit attempt Less than 5% permanently succeed in quitting each year

5. Race/Ethnicity American Indian 32.7% Hispanics 16.7% Asians 12.4% Socio Economic Status Below Poverty Level 31.4% At or Above Poverty Level 23.0% GED 47.8% 9-11 Grades 34.3% Professional Degree 9.5% Medicaid Population 33% (est) Factors Associated with Tobacco Use Prevalence

6. Effective Interventions for Tobacco Cessation 1. 1.Increasing the unit price of tobacco products 2. 2.Smoking bans and restrictions 3. 3.Mass media campaigns 4. 4.Physician intervention – 5A’s 5. 5.Counseling (individual, group, quitlines) 6. 6.Pharmacotherapy (6 FDA approved medications) 7. 7.Reducing patient out-of-pocket costs 8. 8.Reminder systems (for clinical settings) Sources: PHS Clinical Guideline on Treating Tobacco Use and Dependence (2000); Hopkins, et al. Reviews of evidence regarding interventions to reduce tobacco use and exposure to environmental tobacco smoke. AJPM (2001). For status in the states, see www.ctcinfo.org

7. Resources CTC’s website www.ctcinfo.org -E newsletter -Medicaid Toolkit -Roundtable Report CTFK’s Website www.tobaccofreekids.org Partnership to Help Pregnant Smokers Quit www.helppregnantsmokersquit.org