Full-Coverage, Smoking-Cessation Programs Can Help More Smokers Quit

Impact of co-payments on use of smoking-cessation services in an HMO

From 1993 to 1996, researchers at the Group Health Cooperative of Puget Sound, Seattle, assessed the impact of different insurance coverage structures on the utilization and cost effectiveness of smoking-cessation services in a health maintenance organization.

The demand for stop-smoking programs as well as patients' incentives to quit were measured and compared under four different coverage structures, each of which paid for different portions of two categories of smoking treatment: behavioral programs and nicotine replacement therapy.

The project was part of the Robert Wood Johnson Foundation's (RWJF) national program Tobacco Policy Research and Evaluation Program.

Key Findings:

  • The study found that smokers with full coverage had the highest use rates of smoking-cessation services.

    The summary of the researchers' article in The New England Journal of Medicine states, "After adjusting for differences in rates of use during the first year of coverage, we estimated that 10 percent of smokers per year would use smoking-cessation services under full coverage, as compared with 2.4 percent under reduced coverage.

    Even with a slightly lower smoking-cessation rate under full coverage, we estimated that at least one and a half times as many smokers would quit per year under full coverage as under any of the other three coverage plans."

    Average cost to the health plan per user who quit ranged from $797 in the standard plan to $1,171 in the full coverage plan.