Medicare Support Pays Off For Senior Smokers Trying To Quit

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Smoking / Quit Smoking
Article Date: 19 Aug 2008 - 1:00 PDT

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New research suggests that Medicare could help seniors stop smoking by providing nicotine patches and a telephone hotline to those who want to quit.

Nearly 20 percent of seniors who tried that approach managed to quit smoking for a year, according to a study designed to gauge how much smoking-cessation efforts will cost Medicare.

"From a public health perspective, it works," said study lead author Geoffrey Joyce, a senior economist with RAND, which provides research services to the government.

Most antismoking efforts focus on younger people. "Nobody has really paid attention to the elderly," Joyce said.

However, older people can benefit from quitting, even if they have smoked for decades. According to a 1986 study, a senior who smokes 20 or more cigarettes a day and quits at age 65 could expect to add two to three years to his or her life.

Joyce said the question for Medicare is this: Is it cost-effective to help seniors quit smoking? To find an answer, Medicare commissioned the new study, which appears in the latest online issue of the journal Health Services Research.

The researchers examined the experiences of 7,354 seniors who enrolled in smoking cessation programs in seven states between 2002 and 2003. They provided all participants with a self-help kit and divided them into four groups.

The members of the first group received a brochure about smoking cessation. Another group received reimbursement for four brief counseling sessions with their doctors. The third group received counseling plus a nicotine patch or the smoking-cessation drug bupropion. The final group could use a smoking-cessation hotline and a nicotine patch.

Nineteen percent of those in the fourth group quit smoking and did not pick up cigarettes again for the next year. The one-year quit rates for the other three groups were 10 percent, 14 percent and 16 percent, respectively.

Joyce said the difference between the 10 percent quit rate in the brochure group and the 19 percent quit rate in the hotline and patch group was significant: "You can double quit rates with a telephone quitline and a free patch."

Helen Ann Halpin, director of the Center for Health and Public Policy Studies at the University of California at Berkeley, said the study results suggest that "older smokers are motivated to quit and that quitlines and pharmacotherapy greatly increase the odds of successfully quitting."

She added that all 50 states now have a quitline for smokers of all ages.

As for Medicare's need for cost-effective care, "what we don't know is how much money this really saves if saving money is your goal," Joyce said. Still, it seems clear that "if you just look at it from a strict budget perspective, it's not going to save Medicare a lot one way or another."

Health Services Research is the official journal of the AcademyHealth and is published by John Wiley & Sons, Inc. on behalf of the Health Research and Educational Trust.

Joyce G, et al. The effectiveness of covering smoking cessation services for Medicare beneficiaries. Health Services Research online, 2008.

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