By Tom Hopkins
Quitting smoking today is the number one thing that Californians can do to improve their health. Not a moment goes by without a citizen of our country and the State of California suffering from the hazards of tobacco use. Tobacco use has far reaching ramifications that encompass not only health issues, but widespread economic issues.
The difficulty that physicians, patients, and health care workers face today lies in the lack of accessible resources available to treat the ills of tobacco dependence.
Today, smoking is the number one preventable cause of death in the United States, and smoking-related illnesses are among the most dominant and preventable of all health issues. The U.S. Surgeon General cites tobacco as the single greatest cause of disease and premature death in America today. In California, there are nearly 5 million current adult smokers. Nationwide, more than 48 million Americans smoke, and 70 percent admit they want to quit. Even though seven in ten California smokers wants to quit, many smokers, particularly low-income Californians, lack the tools necessary to help them succeed.
As a practicing physician who specializes in treating chronic diseases including tobacco dependence and its health consequences, I continue to be frustrated by my inability to assist patients who lack coverage for medications and counseling services that would help treat their tobacco addiction.
We as a nation and a State can no longer afford to sit back and watch people die. The health of our children will be jeopardized by a well-known health hazard. If there is a smoking gun, it is our society that is holding it!
We can no longer afford to use an economic excuse for not covering the costs for smoking cessation treatments. The figures overwhelmingly demonstrate that coverage is a smart financial investment for governments, insurance companies and employers.
Nationwide, the total economic burden of smoking is at $193 billion. Indirect costs due to lost productivity from smoking-related illnesses in California total in the billions. The average cost for the package of covered smoking cessation services – including counseling and medication – is estimated at $487.50. In contrast, one smoker costs the Medicaid program in California an additional $1,951 per year over their lifetime. If only 10 percent of smokers quit, after five years, California Medicaid would save $59 million annually. If 50 percent of smokers quit, after five years, California Medicaid would save $296 million every year on smoking-related illnesses.
California now has an opportunity to take a stand against the hazardous health consequences of tobacco use and addiction. As we embark on Federal Health Reform implementation in California, it is time that we lend support to Californians who want to quit smoking.
Federal health reform was a good start, but under that plan, many insurers won’t have to cover smoking cessation treatments for years, or even a decade, and many patients who smoke will not even know they’ve gained coverage for the benefit.
If a Californian decides to quit smoking today, the best thing that we can do for his/her health and for the economy of California is to provide access to the full suite of CDC-recognized treatment options now, and to continue to cover different treatments and the doctor and patient try to find what works.
We know that quit-smoking programs are effective, but studies have also shown that it takes five to seven attempts to quit smoking. Many health plans currently cover only one attempt to quit per lifetime of a patient.
Federal health reform legislation requires that all new health insurance plans cover smoking cessation treatment with no cost sharing for American consumers.
California can improve on that piece of the federal reform. We can define what that benefit looks like for Californians, and we can make it available sooner, as opposed to years down the road. We can also make sure that all existing health plans cover access to proven treatment options recommended by the Centers for Disease Control.
If we do this, we will save lives, and money.
Dr. Tom Hopkins is the medical director for Employee Health and Chairman of the Utilization Management Team at Sutter Medical Center in Sacramento and former Medical Director for the Tobacco Cessation Program and Bariatric Program for Sutter Medical Center.
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