Fewer places to smoke, more ways to quit
06/30/05
If you no longer can find a place to smoke as regulations tighten, how about quitting?
More Wisconsin insurers and employers are offering coverage for smoking cessation medication, according to a survey by the University of Wisconsin Center for Tobacco Research and Intervention.
Coverage increased about 32 percent from 2002 to 2004, the survey of Wisconsin health plans found.
Three-fourths of the more than 3 million Wisconsin residents covered by the 23 insurers surveyed had coverage for at least one stop-smoking medication in 2004, up from 56 percent of 19 insurers surveyed two years earlier.
Bupropion (Zyban) and the nicotine patch are the most frequently covered medications, followed by other nicotine replacement products such as the inhaler and gum and nasal spray.
Some type of cessation counseling was available to 70 percent of those covered. For 5 percent of the plans, that included use of a quit call line to deliver counseling services. (The Wisconsin Tobacco Quit Line - (800) 270-STOP - is available to all state residents, regardless of insurance coverage.)
The reason most often cited by health plans for not covering tobacco cessation treatment is worry that employees might leave before there is a return on investment. But others have found a return on investment in as little as two years.
"We've found significant short- and long-term benefits from helping people quit smoking by covering costs and offering classes and materials," said Dr. Marvin Wiener, medical director for Unity Healthcare.
"In the short term, we see fewer respiratory infections and faster recovery from illness and surgery. Long term, we know smoking is a cause of emphysema, chronic bronchitis, lung cancer and heart disease. It makes sense to decrease these diseases."
In Wisconsin, illnesses caused by smoking cost an estimated $1.6 billion annually in direct health-care costs and an additional $1.4 billion in lost productivity, according to the research center, which said those costs are leading more employers to offer coverage.
"We recognized the hazards of tobacco use and wanted to help our employees get free of smoking," said Bill Vancos, human resources manager at Wausau Paper. "We also know that smokers are less productive and more prone to use health benefits. So we decided to couple quit-smoking reimbursement for medications and cessation programs with a smoke-free policy."
Coverage provided by some health plans had significant gaps, however.
Some plans offer the benefits only once in a lifetime, not recognizing that smokers often relapse and try several times before quitting. Others offer only limited follow-up.
Only 10 health plans covered combinations of medication, and some only covered an hour of cessation counseling.
Nevertheless, "We've made a lot of progress," said Gloria Meyer of the Center for Tobacco Research and Intervention.