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Research & Evidence: Tobacco Cessation
Comprehensive cessation coverage increases use of evidence-based cessation treatments and increases quit rates.
Coverage for Tobacco Use Cessation Treatments
Centers for Disease Control and Prevention
Walton, MS, Kimp; Teresa W. Wang, PhD; Gillian L. Schauer, PhD; Sean Hu, MD; Henraya F. McGruder, PhD; Ahmed Jamal, MBBS; Stephen Babb, MPH. "State-Specific Prevalence of Quit Attempts Among Adult Cigarette Smokers - United States, 2011-2017." Centers for Disease Control and Prevention - Morbidity and Mortality Weekly Report, July 19, 2019.
From 1965 to 2017, the prevalence of cigarette smoking among U.S. adults aged ≥18 years decreased from 42.4% to 14.0%, in part because of increases in smoking cessation (1,2). Increasing smoking cessation can reduce smoking-related disease, death, and health care expenditures (3). Increases in cessation are driven in large part by increases in quit attempts (4). Healthy People 2020 objective 4.1 calls for increasing the proportion of U.S. adult cigarette smokers who made a past-year quit attempt to ≥80% (5). To assess state-specific trends in the prevalence of past-year quit attempts among adult cigarette smokers, CDC analyzed data from the 2011–2017 Behavioral Risk Factor Surveillance System (BRFSS) surveys for all 50 states, the District of Columbia (DC), Guam, and Puerto Rico. During 2011–2017, quit attempt prevalence increased in four states (Kansas, Louisiana, Virginia, and West Virginia), declined in two states (New York and Tennessee), and did not significantly change in the remaining 44 states, DC, and two territories. In 2017, the prevalence of past-year quit attempts ranged from 58.6% in Wisconsin to 72.3% in Guam, with a median of 65.4%. In 2017, older smokers were less likely than younger smokers to make a quit attempt in most states. Implementation of comprehensive state tobacco control programs and evidence-based tobacco control interventions, including barrier-free access to cessation treatments, can increase the number of smokers who make quit attempts and succeed in quitting (2,3).
Schnoll R, Leone F, Veluz‐Wilkins A,et al. . "A randomized controlled trial of 24 weeks of varenicline for tobacco use among cancer patients: Efficacy, safety, and adherence." Psycho‐Oncology, January 24, 2019.
Continuing to smoke after a cancer diagnosis undermines prognosis. Yet few trials have tested Food and Drug Administration (FDA)‐approved tobacco use medications in this population. Extended use varenicline may represent an effective treatment for cancer patients who smoke given barriers to cessation including a prolonged time line for relapse.
Halpern, Scott D., M.D., Ph.D., Michael O. Harhay, Ph.D., Kathryn Saulsgiver, Ph.D., Christine Brophy, Andrea B. Troxel, Sc.D., and Kevin G. Volpp, M.D., Ph.D.. "A Pragmatic Trial of E-Cigarettes, Incentives, and Drugs for Smoking Cessation." New England Journal of Medicine, June 14, 2018.
BACKGROUND: Whether financial incentives, pharmacologic therapies, and electronic cigarettes (e-cigarettes) promote smoking cessation among unselected smokers is unknown.
CONCLUSIONS: In this pragmatic trial of smoking cessation, financial incentives added to free cessation aids resulted in a higher rate of sustained smoking abstinence than free cessation aids alone. Among smokers who received usual care (information and motivational text messages), the addition of free cessation aids or e-cigarettes did not provide a benefit. (Funded by the Vitality Institute; ClinicalTrials.gov number, NCT02328794.)
Scott Gottlieb, M.D., and Mitchell Zeller, J.D. "A Nicotine-Focused Framework for Public Health." New England Journal of Medicine, August 6, 2017.
Despite extraordinary progress in tobacco control and prevention, tobacco use remains the leading cause of preventable disease and death in the United States. Combustible cigarettes cause the overwhelming majority of tobacco-related disease and are responsible for more than 480,000 U.S. deaths each year. Indeed, when used as intended, combustible cigarettes kill half of all long-term users.
Ralph S. Caraballo, PhD ; Paul R. Shafer, MA ; Deesha Patel ; Kevin C. Davis, MA ; Timothy A. McAfee, MD. "Quit Methods Used by US Adult Cigarette Smokers, 2014–2016." Centers for Disease Control and Prevention, April 13, 2017.
Quitting cigarette smoking greatly reduces the risk of developing smoking-related diseases; although the health benefits are greater for people who stop at earlier ages, there are benefits at any age (1). The use of electronic cigarettes (e-cigarettes) has increased in the United States (2). Little is known about how the rise in e-cigarette use, particularly among current and former adult cigarette smokers, may have affected quitting behaviors. This study assessed common methods used to try to quit cigarettes among a nationally representative online sample of US adult current smokers surveyed from April 2014 through June 2016.
"Coverage for Tobacco Use Cessation Treatments." Centers for Disease Control and Prevention, 2014.
This updated 2014 document provides an overview of the evidence base for tobacco cessation insurance coverage, best practices for designing cessation coverage, and the current status of cessation coverage.
"Best Practices for Comprehensive Tobacco Control Programs ." Centers for Disease Control and Prevention, 201.
Tobacco use is the single most preventable cause of disease, disability, and death in the United States. Nearly one-half million Americans still die prematurely from tobacco use each year, and more than 16 million Americans suffer from a disease caused by smoking. Despite these risks, approximately 42.1 million U.S. adults currently smoke cigarettes. And the harmful effects of smoking do not end with the smoker. Secondhand smoke exposure causes serious disease and death, and even brief exposure can be harmful to health. Each year, primarily because of exposure to secondhand smoke, an estimated 7,330 nonsmoking Americans die of lung cancer and more than 33,900 die of heart disease. Coupled with this enormous health toll is the significant economic burden. Economic costs attributable to smoking and exposure to secondhand smoke now approach $300 billion annually.
Fitch, Kate, RN, MEd; Kosuke Iwasaki, FIAJ, MAAA; Bruce Pyenson, FSA, MAAA. "Covering Smoking Cessation as a Health Benefit." Milliman: Consultants and Actuaries, December 6, 2006.
This report provides information so employers can make informed choices based on the costs and benefits of smoking cessation programs – and compare these to other routinely provided benefits.