Does State Medicaid Coverage of Smoking Cessation Treatments Affect Quitting?

OBJECTIVE: Cigarette smoking and smoking-related diseases disproportionately affect low-income populations. Health insurance coverage of smoking cessation treatments is increasingly used to encourage quitting. We assess the relationship between state Medicaid coverage of smoking cessation treatments and past-year quitting in adult Medicaid beneficiaries.

DATA SOURCES: 2009-2014 National Health Interview Survey (NHIS); 2008-2013 indicators of state Medicaid coverage of smoking cessation treatments.

STUDY DESIGN: A triple-differencing specification based on differences in Medicaid cessation coverage policies across states as well as within-state differences between Medicaid beneficiaries and a counterfactual group of low-income adults not covered by Medicaid.

DATA COLLECTION/EXTRACTION METHODS: Individual-level NHIS data with restricted geographical identifiers were merged with state-year Medicaid coverage indicators.

PRINCIPAL FINDINGS: Combined coverage of both cessation counseling and medications in state Medicaid programs was associated with increased quitting, with an estimated mean increase in past-year quitting of 3.0 percentage points in covered Medicaid beneficiaries relative to persons without coverage.

CONCLUSIONS: Combined coverage of both smoking cessation counseling and medication by state Medicaid programs could help reduce cigarette smoking among Medicaid beneficiaries.