A Great American Smokeout, but where’s the coverage to help people quit?

Today is the Great American Smokeout, and while San Franciscans are doing their part to help people battle nicotine addiction, I became aware recently that not all the health insurance plans for our county workers in San Francisco  — nor in many other counties around California – were covering all of the smoking cessation benefits recommended by the Center for Disease Control.

The City of San Francisco has embraced a multi-faceted approach to reduce tobacco use, while protecting individuals from insurance coverage barriers as they battle their addiction to nicotine:

  • We have endorsed a policy calling on the health plans that provide health insurance coverage for City and County employees to offer comprehensive smoking cessation benefits consistent with Centers for Disease Control and Prevention guidelines.
  • The City of San Francisco covers smoking cessation services and treatments for the uninsured.

According to the CDC, the most effective health insurance benefits are those that include patient reimbursements for smoking cessation counseling and FDA-approved pharmacotherapeutic treatments, and reimbursements to clinicians for providing tobacco dependence treatment, just as they are reimbursed for treating other chronic conditions.

Specifically, CDC guidelines state that comprehensive smoking cessation benefits should:

  • Cover at least four counseling sessions of at least 30 minutes each
  • Cover both FDA-approved prescription medication and over-the-counter nicotine replacement treatments
  • Provide counseling and medication coverage for at least two smoking cessation attempts per year
  • Eliminate or minimize co-pays or deductibles for counseling and medications

I have written a letter to my fellow county health officers asking
them to please advocate for health insurance plans in their counties,
especially those that cover county workers, cover the full range of
smoking cessation methods.

We also sent a letter to all health plans that provide health
insurance coverage for City of San Francisco employees, calling on them
to offer CDC model of comprehensive smoking cessation benefits.

As Health Officers, I believe we have a responsibility to ensure our
city and counties, as well as the health insurance companies that
provide benefits to our employees and families, proactively support
smokers to the fullest extent possible in quitting. By calling on
health plans to provide smokers with comprehensive smoking cessation
benefits we can save millions of lives, reduce the unnecessary costs to
our health care system, and help prevent a new generation of smokers.

Dr. Mitchell Katz is the health officer for San Francisco County.

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1 reply »

  1. Excellent article, Dr. Katz! It is about time that insurers stop rather paying for lung surgery than for preventive steps or stop smoking programs.
    We usually also recommend that clients check with their employers flexible spending plan, as that often reimburses the cost for smoking cessation.