The federal government is offering low-cost treatment to Florida senior smokers looking to kick the habit, in what may be the first step toward Medicare someday covering smoking cessation drugs and counseling.

The Centers for Medicare & Medicaid Services has announced a $14 million pilot program that will offer four types of therapies to 43,000 Medicare beneficiaries in seven states -- Florida, Alabama, Missouri, Nebraska, Ohio, Oklahoma and Wyoming. Participants' progress will be tracked as part of a study on the best way to help older smokers quit. CMS is not saying whether the study is an initial move toward recommending the coverage of smoking cessation, action that would require congressional approval. But over the past two decades, screenings or treatments that research has shown prevent serious health problems eventually have slipped under Medicare's umbrella. Flu shots, mammograms and tests for prostate cancer now are covered benefits, and glaucoma screening will be covered next year. "I wouldn't be at all surprised to see them cover cessation programs," said Larry Polivka, director of the Florida Policy Exchange Center on Aging at the University of South Florida. Study subjects will be assigned one of four therapies, according to where they live: specialized counseling; specialized counseling plus either the nicotine patch or the smoking cessation drug bupropion; counseling through a telephone hotline plus the nicotine patch; or stop-smoking information from their regular physician. Participants will be assessed a small co-payment for the drugs and, in some cases, the counseling. Participants must be 65 or older, intend to live in the same area for the next nine months and have Medicare Part B fee-for-service coverage. That means snowbirds and seniors enrolled in Medicare HMOs are not eligible. Those interested should call 866-652-3446 to apply. CMS claims that older smokers will notice improvements in circulation and breathing shortly after they quit and that their risk of heart disease and stroke will drop within a year. Seventy percent of all smoking-related deaths occur in people age 65 and older, and smoking-related illnesses will cost Medicare $800 billion between 1995 and 2015, according to CMS. "We've been trying to identify some preventable senior health issues we could work on, and this was one," said CMS spokesperson Jennie McGihon. The study comes as Congress debates adding another benefit to Medicare, coverage of prescription medications. But covering drugs is a huge financial undertaking, as most of Medicare's 40 million beneficiaries are on at least one medication. By comparison, only 15 percent of Americans 65 to 74 years old, and less than 5 percent of those age 85 and older, smoke daily, according to the Centers for Disease Control and Prevention. A 2000 CDC report suggested that giving smoking cessation advice to Medicare recipients could encourage 25,000 older smokers to quit each year.

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