Dataset Information

Massachusetts Medicaid members that smoked in 2008: Characteristics associated with smoking status in 2014.

ABSTRACT: The smoking rate among non-elderly Medicaid enrollees is more than double the rate for those privately insured; smoking-related conditions account for 15% of Medicaid expenditures. Under state health reform, Massachusetts Medicaid (MassHealth) made tobacco cessation treatment available beginning in 2006. We used surveys conducted in 2008 and 2014 to examine changes in smoking abstinence rates among MassHealth members identified as smokers and to identify factors associated with being a former smoker. Members previously identified as smokers were surveyed by mail or phone; 2008 and 2014 samples included 3,116 and 2,971 members, respectively. Surveys collected demographic and health information, asked members whether they smoked cigarettes "every day, some days or not at all', and asked questions to assess smoking intensity among current smokers. The 2014 survey included an open ended-question asking members "what helped the most" in quitting or quit attempts. We observed a significant decrease in members reporting smoking "every/some days" of 15.5 percentage points (p < .0001) from 2008 to 2014, and a significant decrease in smokers reporting smoking "more than 10 cigarettes on days smoked" of 16.7 percentage points (p < .0001). Compared to smokers, former smokers more frequently reported health concerns, the influence of family members, and the use of e-cigarettes as helping the most in quitting. Expanded access to tobacco cessation treatment under the Affordable Care Act may have help to reduce the high smoking rates among Medicaid enrollees. Additionally, smokers' concerns about health and the influence of family and friends provide opportunities for targeted intervention and messaging about quitting.

SUBMITTER: Henry AD

PROVIDER: S-EPMC5638442 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Massachusetts Medicaid members that smoked in 2008: Characteristics associated with smoking status in 2014.

Henry Alexis D AD Gettens John J Savageau Judith A JA Cullen Doris D Landau Anna A

PloS one 20171012 10

The smoking rate among non-elderly Medicaid enrollees is more than double the rate for those privately insured; smoking-related conditions account for 15% of Medicaid expenditures. Under state health reform, Massachusetts Medicaid (MassHealth) made tobacco cessation treatment available beginning in 2006. We used surveys conducted in 2008 and 2014 to examine changes in smoking abstinence rates among MassHealth members identified as smokers and to identify factors associated with being a former sm ...[more]

PMID: 29023542

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Project description:Low-income populations are especially likely to smoke and have difficulty quitting. This study evaluated a monetary incentive intended to increase smoking treatment engagement and abstinence among Medicaid recipients who smoke.Two-group randomized clinical trial of Incentive (n=948) and Control interventions (n=952) for smoking.Medicaid recipients recruited from primary care patients (n=920) and callers to the Wisconsin Tobacco Quit Line (n=980).Participants were offered five quitline cessation calls and were encouraged to obtain cessation medication (covered by Medicaid). All participants received payment for completing a baseline assessment and a 6-month smoking test. Only Incentive condition participants received compensation for taking counseling calls ($30 per call) and for biochemically verified abstinence at the 6-month visit ($40).Seven-day point-prevalence smoking abstinence 6-months post study entry and cost/quit.Incentive condition participants had significantly higher biochemically determined 7-day point-prevalence smoking abstinence rates 6 months after study induction than did Controls (21.6% vs 13.8%, respectively, p<0.0001). A positive treatment effect of incentives was present across other abstinence indices, but the size of effects and levels of abstinence varied considerably across indices. Incentive condition participants were also significantly more likely than non-incentivized Control participants to accept Wisconsin Tobacco Quit Line treatment calls and their acceptance of calls mediated their attainment of higher abstinence rates at 6-month follow-up. The cost/quit/participant averaged $4,268.26 for the Control participants and $3,601.37 for the Incentive participants.This study shows that fairly moderate levels of incentive payments for treatment engagement and abstinence (a total possible payment of $190) increased very low-income smokers' engagement and success in smoking cessation treatment.This study is registered at www.clinicaltrials.gov: NCT02713594.

Project description:ObjectiveTo assess state coverage and utilization of Medicaid smoking cessation medication benefits among fee-for-service enrollees who smoked cigarettes.MethodsWe used the linked National Health Interview Survey (survey years 1995, 1997-2005) and the Medicaid Analytic eXtract files (1999-2008) to assess utilization of smoking cessation medication benefits among 5,982 cigarette smokers aged 18-64 years enrolled in Medicaid fee-for-service whose state Medicaid insurance covered at least one cessation medication. We excluded visits during pregnancy, and those covered by managed care or under dual enrollment (Medicaid and Medicare). Multivariate logistic regression was used to determine correlates of cessation medication benefit utilization among Medicaid fee-for-service enrollees, including measures of drug coverage (comprehensive cessation medication coverage, number of medications in state benefit, varenicline coverage), individual-level demographics at NHIS interview, age at Medicaid enrollment, and state-level cigarette excise taxes, statewide smoke-free laws, and per-capita tobacco control funding.ResultsIn 1999, the percent of smokers with ?1 medication claims was 5.7% in the 30 states that covered at least one Food and Drug Administration (FDA)-approved cessation medication; this increased to 9.9% in 2008 in the 44 states that covered at least one FDA-approved medication (p<0.01). Cessation medication utilization was greater among older individuals (? 25 years), females, non-Hispanic whites, and those with higher educational attainment. Comprehensive coverage, the number of smoking cessation medications covered and varenicline coverage were all positively associated with utilization; cigarette excise tax and per-capita tobacco control funding were also positively associated with utilization.ConclusionsUtilization of medication benefits among fee-for-service Medicaid enrollees increased from 1999-2008 and varied by individual and state-level characteristics. Given that the Affordable Care Act bars state Medicaid programs from excluding any FDA-approved cessation medications from coverage as of January 2014, monitoring Medicaid cessation medication claims may be beneficial for informing efforts to increase utilization and maximize smoking cessation.

Project description:IntroductionThe current study examined the relationship between acute (past 30 day) and recent (past year but not past 30 day) serious psychological distress (SPD) and smoking during pregnancy among women in the United States overall, stratified by demographic characteristics, and described the change in the prevalence of prenatal smoking among women with and without SPD, from 2008 to 2014.MethodsData were drawn from the National Survey on Drug Use and Health (NSDUH), an annual cross-sectional study of US persons aged 12 and over. SPD and smoking in the past 30 days among pregnant women, aged 18 and older, were examined using logistic regression models. Heterogeneity in this association by demographic characteristics, trends over time, and level of cigarette consumption was also examined.ResultsPrenatal smoking was common. Almost 40% of pregnant women with acute SPD reported smoking, 23% of pregnant women with recent SPD smoked, and 11.7% of pregnant women without recent SPD smoked. No significant change was found in the prevalence of prenatal smoking from 2008 to 2014 in any of these groups. Robust relationships were found between acute (OR = 5.05 [3.64-6.99]) and recent SPD (OR = 2.37 [1.74-3.24]) and smoking; these findings remained after adjusting for demographics.ConclusionsSPD and smoking during pregnancy are strongly associated; this relationship is present across all sociodemographic groups and the prevalence of smoking in pregnancy has remained relatively unchanged over the past decade both in the presence and absence of SPD.ImplicationsSPD and smoking in pregnancy are robustly linked; the prevalence of smoking in pregnancy is extremely high in women with SPD. Screening women with mental health problems for prenatal smoking, as well as screening pregnant smokers for mental health problems, seems warranted and may assist more women in seeking and utilizing treatment options. Efforts to reduce the prevalence of smoking during pregnancy might specifically target women with SPD, where the potential for impact is substantial.

Dataset Information

Massachusetts Medicaid members that smoked in 2008: Characteristics associated with smoking status in 2014.

Publications

Massachusetts Medicaid members that smoked in 2008: Characteristics associated with smoking status in 2014.

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