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State Cancer Legislative Database Update, NCI Legislative Data Byte
States with Laws Addressing Coverage for Tobacco Dependency
Treatment by Private Health Insurance Plans (enacted as of March 31, 2010)
Among current U.S. adult smokers, 70 percent report that they For this and other reasons, smokers often do not obtain initial or want to quit completely, and millions have attempted to quit smoking.1 The 2008 Clinical Practice Guidelines on Treating Tobacco Some state lawmakers have begun to address access to affordable Dependence 2 (Guidelines), published by the U.S. Department of treatment for tobacco dependence by enacting laws that require Health and Human Services Public Health Service, recommends insurers to provide coverage for cessation treatments and various counseling and medication treatment options for tobacco services. As of March 31, 2010, 21 states have laws addressing dependence. Regarding counseling, the Guidelines specify that third-party coverage or reimbursement for treatment of intense individual, group, and telephone counseling are effective tobacco use dependency. Of those 21 states, only 4—Colorado,
for tobacco cessation. In addition, the guidelines recommend seven Maryland, Oregon, and Rhode Island—have laws that require
medications that are proven to reliably treat tobacco dependence private insurers to cover smoking cessation treatment. The and sustain long-term smoking abstinence. law in Maryland specifies that coverage must be provided for
Of the medications recommended, two are prescription drug prescription NRTs and prescription drugs and Rhode Island’s
treatments (bupropion SR and varenicline) and five are nicotine law specifies that coverage must include prescription drugs and counseling services. The laws in Colorado and Oregon do not
specify covered treatments. Three states—California, New Jersey,
and New Mexico—require private insurers to offer coverage for
tobacco dependency treatment. Laws in other states vary, but Although counseling services and medications are proven to be generally: (1) require coverage for smoking cessation by state independently effective, the Guidelines suggest that clinicians Medicaid or state employee health plans, or (2) authorize health consider and promote the use of both as the most effective plans to offer incentives or rewards for participation in tobacco tobacco dependency treatment. Guidance from the American Cancer Society Web site to help smokers manage the physical aspects of addiction states that pairing NRTs with a program 1. Centers for Disease Control and Prevention. (2002). Cigarette smoking that provides support for behavior modification can double the among adults—United States, 2000 [Electronic version}. Morbidity and chances of permanently quitting the smoking habit. 3 Mortality Weekly Report 51(29), 642–645.
2. Fiore, M.C., Jaen, C.R., Baker, T.B., et al. (2008, May) Treating tobacco use and While counseling and cessation aids have been proven to dependence: 2008 update. Clinical Practice Guideline. Rockville, MD: help smokers quit, tobacco dependence is a chronic condition U.S. Department of Health and Human Services. Public Health Service.
that often requires repeated intervention.2 NRTs, prescription medications, and counseling can be expensive, and treatment is 3. American Cancer Society (2009, November 23). Guide to quitting smoking.
Retrieved April 14, 2010, from http://www.cancer.org/docroot/PED/ generally not provided under individual health insurance plans. content/PED_10_13X_Guide_for_Quitting_Smoking.asp.
SCLD contains information synthesized from state-level laws and resolutions. It does not contain state-level regulations; executive orders; measures implemented by counties, cities, or other localities; opinions of Attorneys General; or data addressing the implementation of state laws—all of which may vary significantly from the laws reported herein. Although coverage of Medicaid and Medicare law is not comprehensive, some SCLD records include these data.

Source: http://www.scld-nci.net/linkdocs/products/databytes130.pdf