Addressing Tobacco in Managed Care, a national program of the Robert Wood Johnson Foundation (RWJF) (renamed Addressing Tobacco in Health Care in 2005), supported evaluations of replicable efforts by managed care organizations to integrate effective tobacco-cessation interventions into everyday clinical practice and the basic health care these organizations provide.

Authorized by the Board of Trustees in October 1996 for $6.76 million, Addressing Tobacco in Managed Care funded 25 projects from 1997 through 2005 to evaluate changes in organizational/institutional policies and practices aimed at reducing rates of tobacco use and the harm caused by tobacco use among managed care subscribers. A collaboration among managed care organizations and academic researchers carried out each project.

Research Program Assessment Findings
The Lewin Group conducted an assessment of the impact of the Addressing Tobacco in Managed Care research program in 2003:

• Addressing Tobacco in Managed Care increased managed care organizations' awareness of the need for tobacco screening and cessation services.
• The program was instrumental in developing a research base and a cadre of researchers examining tobacco-cessation interventions and the institutional changes needed to promote them.
• Addressing Tobacco in Managed Care influenced changes within health systems and helped to "normalize" support for smoking cessation within health systems.
• The program produced high-quality, useful research findings.
• With its focus on "real-world" studies, Addressing Tobacco in Managed Care identified replicable, cost-effective, high-impact changes in health care systems relevant to tobacco cessation, as well as challenges and barriers to making those changes.
• The findings from Addressing Tobacco in Managed Care have applicability for health behaviors and conditions beyond tobacco use.
• The national research program office fostered partnerships and collaboration between tobacco researchers and managed care plans.

Key Research Findings
Among the findings reported by the researchers who received grants under the program were:

• By capitalizing on the unique strengths of managed care organizations, feasible and replicable improvements in tobacco-dependence treatment delivery are achievable.
• Systems innovations can increase the provision of evidence-based treatment to underserved and socioeconomically disadvantaged populations.
• Reaching out to dental practices can foster tobacco user intervention.
• Patient satisfaction is improved by providing tobacco-dependence treatments.
• Electronic medical records are a promising means of documenting and facilitating the identification of smokers and the delivery of smoking-cessation interventions.
• No single strategy or systems change will ensure that all tobacco users receive evidence-based care.

Program Management
A national research program office, housed at the University of Wisconsin at Madison, and a national technical assistance office, housed at America's Health Insurance Plans in Washington, oversaw the program and provided technical assistance to the projects.

After the Program: Expanding the Research Network
In late 2005, RWJF awarded a two-year grant of $400,000 (ID# 048283) to the national program office to continue to support the existing network of tobacco-control researchers examining tobacco-control strategies and their partners, to provide them with technical assistance and to disseminate information and tools for implementing changes. The Foundation renamed the program Addressing Tobacco in Health Care in 2006 to attract a broader array of health services and tobacco control researchers to the new networking activities and extend the program's outreach to a variety of health care systems and insurers.