Policies Affecting Medicaid Beneficiaries’ Smoking Cessation Behaviors

Brantley, Erin; Greene, Jessica; Bruen, Brian; Steinmetz, Erika; Ku, Leighton

doi:10.1093/ntr/nty040

Cited by 14 publications

(16 citation statements)

References 29 publications

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“…4 Medicaid programs, therefore, need effective, scalable strategies to help the large numbers of smokers they cover. 4,7,8 By layering modest incentives and mailed patches onto an existing, accessible, evidence-based quitline service, this study expands the menu of effective interventions. All states in the U.S. have a quitline providing telephone counseling and could easily offer these adjunctive services to their Medicaid callers, given adequate funding.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 The growing concentration of smokers in Medicaid highlights the need for more effective policies to reduce tobacco use in this population. 4,7,8 One promising but understudied approach is to offer smokers in Medicaid a financial incentive to quit. It has reasonably been proposed that such incentives may have the greatest impact in populations with the least purchasing power.…”

Section: Introductionmentioning

confidence: 99%

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Incentives and Patches for Medicaid Smokers: An RCT

Anderson

Cummins

Kohatsu

et al. 2018

American Journal of Preventive Medicine

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incentives and Patches for Medicaid Smokers: An RCT

Anderson

Cummins

Kohatsu

et al. 2018

American Journal of Preventive Medicine

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“…It could also help shift the focus of Medicaid policy beyond basic coverage of treatment 23−25 toward a more proactive, comprehensive approach to tobacco cessation. 20,26,27 Limitations This study had limitations. First, although efforts were made to ensure that the distribution of flyers was as random as possible, operational constraints made it impractical to mix all flyers prior to fulfillment.…”

Section: Discussionmentioning

confidence: 96%

Effects of Offering Nicotine Patches, Incentives, or Both on Quitline Demand

Anderson

Kirby

Tong

et al. 2018

American Journal of Preventive Medicine

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Introduction: Previous studies found that offering free nicotine patches significantly increases calls to quitlines, although most used pre−post designs and did not directly compare the effects of patches and other incentives. The current study with California Medicaid members used a 2 £ 2 design to directly assess the effects of offering free patches and incentives on calls to a quitline. The hypotheses were that offering either would make members more likely to call, and that offering both would increase demand even further. Methods: Flyers were inserted into a mailing sent to 4,268,696 Medicaid households, with one of four offers: (1) free counseling; (2) counseling plus patches; (3) counseling plus a $20 gift card; and (4) counseling plus patches and gift card. Ninety percent received the first offer and 10% received one of the other three offers, in equal proportions. The mailers shipped late 2013 to early 2014. Data were collected 2013−2015 and analyzed 2018. Results: Response rates were 0.029% for counseling, 0.115% for counseling plus patches, 0.122% for counseling plus gift card, and 0.200% for counseling, patches, and gift card. Both patches and gift cards had statistically significant effects (both p < 0.001). Promotional costs were 59%−75% lower with an incentive. Non-whites responded more strongly than whites to a gift card offer. Conclusions: Offering either free patches or a $20 gift card quadrupled the likelihood of Medicaid smokers calling a quitline; offering both had a nearly additive effect. Incentive offers dramatically increased the cost-effectiveness of promotions. Piggybacking on existing Medicaid communications to promote cessation proved very successful. Supplement information: This article is part of a supplement entitled Advancing Smoking Cessation in California's Medicaid Population, which is sponsored by the California Department of Public Health.

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“…This finding is consistent with prior research showing that state Medicaid expansion was associated with increased smoking cessation among low-income adults. 19,33,34 Medicaid-expanded states are different in many ways from non-expanded states, which may explain the difference in odds of clients quitting smoking during treatment. Expanded states may offer more resources to help insured clients quit smoking, including greater access to preventive and primary healthcare services, 37,38 boosting support for clients who both have health insurance and live in a Medicaid-expanded state.…”

Section: Discussionmentioning

confidence: 99%

Association of Medicaid Expansion and Health Insurance with Receipt of Smoking Cessation Services and Smoking Behaviors in Substance Use Disorder Treatment

Yip

Gubner

et al. 2019

J Behav Health Serv Res

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This study examined whether living in a Medicaid-expanded state or having health insurance were associated with receipt of smoking cessation services or smoking behaviors among substance use disorder (SUD) treatment clients. In 2015 and 2016, 1,702 SUD clients in 14 states were surveyed for health insurance status, smoking cessation services received in their treatment program, and smoking behaviors. Services and behaviors were then compared by state Medicaid expansion and health insurance status independently. Clients in Medicaid-expanded states were more likely to be insured (89.9% vs. 54.4%, p < .001) and to have quit smoking during treatment (AOR = 3.77, 95% CI = 2.47, 5.76). Insured clients had higher odds of being screened for smoking status in their treatment program and making quit attempts in the past year. Medicaid expansion supports greater health insurance coverage of individuals in SUD treatment and may enhance smoking cessation.

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Policies Affecting Medicaid Beneficiaries’ Smoking Cessation Behaviors

Cited by 14 publications

References 29 publications

Incentives and Patches for Medicaid Smokers: An RCT

Incentives and Patches for Medicaid Smokers: An RCT

Effects of Offering Nicotine Patches, Incentives, or Both on Quitline Demand

Association of Medicaid Expansion and Health Insurance with Receipt of Smoking Cessation Services and Smoking Behaviors in Substance Use Disorder Treatment

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