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Tobacco-Cessation Support

Provide coverage for evidence-based tobacco-cessation treatments (counseling and FDA-approved prescription and nonprescription medications), at either no cost or at a reasonable cost-sharing level, for all employees and covered dependents enrolled in the employer’s health plans.

Gold Standard employers provide coverage for FDA-approved products to ensure cost is not a barrier in pursuing the most effective therapy for each individual tobacco user.

FDA-approved tobacco cessation medications have all been evaluated to be safe and effective products, and sort into two categories: Nicotine Replacement Therapy (NRT) and non-nicotine over-the-counter (OTC) medications. Several factors affect what will work best for each smoker or other tobacco user, however, so there is no selection of only certain FDA-approved medications that make sense for all or even most individuals. 

The different NRTs work by the same broad principle of providing nicotine at controlled doses. However, they vary in the methods of delivery and the ways they are absorbed and interact with body chemistry. Non-nicotine medications work through different sets of biochemical and physical interactions inside a person’s body.  Meanwhile, individuals have unique medical histories, tobacco use histories, body chemistry profiles, tolerances for side effects, other medications they take, and patterns of daily life at work and at home.

Cessation can be a challenging process for any tobacco user.  When employers provide access to FDA-approved medications, individuals and their health care providers can seek out the most effective treatment match.

Coverage for the following FDA approved tobacco cessation medications are required:

  • Prescription Only (Rx): Bupropion SR 150 (generic or Zyban or Wellbutrin SR)
  • Prescription Only (Rx): Varenicline (Chantix)
  • Over the Counter/OTC/Nonprescription: Nicotine Gum (generic or Nicorette)
  • Over the Counter/OTC/Nonprescription: Nicotine Lozenge (generic or Commit)
  • Over the Counter/OTC/Nonprescription: Nicotine Patch (generic or Nicoderm CQ or Nicotrol)

Coverage for the following FDA approved tobacco cessation medications are optional:

  • Prescription Only (Rx): Nicotine Inhaler (Nicotrol inhaler)
  • Prescription Only (Rx): Nicotine Nasal Spray (Nicotrol NS)

Medications must be available at either no cost or with a co-pay that is line with your other pharmacy benefits. In cases where a generic form of a medication is available, you may choose to provide access to the generic and not the brand.

Provide employer-sponsored tobacco-cessation programming and/or services.

An organization must have programming in place to encourage employees to quit and remain tobacco free. The application provides many suggested ways to meet this requirement, not all required. However, you’ll be required to check off a sufficient number of boxes to demonstrate that programming is in place to help employees quit the use of tobacco. When evaluating your application, the Accreditation Review Board (ARB) will take into consideration your organizations size, number of locations and industry.

Best Practices

Vanderbilt University Medical Center

Smoking is the leading cause of preventable disease and death in the United States. Initiating treatment during hospital admission increases long-term quit rates by 40% or higher. Smoking cessation results in fewer hospital readmissions, fewer total hospital days, and lower smoking-related morbidity as well as elevated quality of life that is sustained for years after the quit date. The activities described below reflect a commitment to addressing the full spectrum of tobacco control, from initial tobacco screening to participation in ongoing research studies to public health outreach and...

Articles of Interest

CA: A Cancer Journal for Clinicians: Volume 69, Issue 2

Research & Evidence

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.
New England Journal of Medicine
Centers for Disease Control and Prevention

Frequently Asked Questions

Pillar 1: Tobacco-Free Workplace

Which tobacco-cessation prescription (Rx) and non-prescription OTC products must be covered at no cost, or at a reasonable cost-sharing level, to the employee and covered dependents?

The following FDA-approved tobacco-cessation Rx and non-prescription OTC products must be covered at either no cost or at a reasonable cost-sharing level.

Available by Prescription Only (Rx):

  •      Bupropion SR 150 (generic or Zyban or Wellbutrin SR)
  •      Varenicline (Chantix)

Available Over the Counter | OTC | Nonprescription:

  •      Nicotine Gum  (generic or Nicorette)
  •      Nicotine Lozenges (generic or Commit)
  •      Nicotine Patch (generic or Nicoderm CQ or Nicotrol)

Coverage for the following FDA-approved and CDC-recommended cessation products are optional:

  •      Nicotine Inhaler (Nicotrol inhaler)
  •      Nicotine Nasal Spray (Nicotrol NS)

Note that this list will change as new medications are approved.

What is meant by “employer-sponsored tobacco-cessation programming"?

Examples include a Quit Line service, onsite smoking cessation classes, and onsite support groups. Gold Standard employers organization must sponsor or promote programs that help employees discontinue the use of tobacco. An organization must demonstrate that it has made a concerted effort to help employees quit the use of tobacco.