CDC COMMUNITY GUIDE: Tobacco Use and Secondhand Smoke Exposure: Reducing Out-of-Pocket Costs for Evidence-Based Cessation Treatments

CDC

An Evidence-Based Practice

Description

Reducing tobacco users' out-of-pocket costs involves policy or program changes that make evidence-based treatments, including medication, counseling or both, more affordable. To achieve this, new benefits may be provided, or changes may be made to the level of benefits offered that reduce costs or co-payments.

Policy and program changes may be communicated to tobacco users and health care providers to increase awareness, interest in quitting, and use of evidence-based treatments.

The Community Preventive Services Task Force (CPSTF) recommends policies and programs to reduce tobacco users' out-of-pocket costs for evidence-based cessation treatments based on strong evidence of effectiveness in increasing the number of tobacco users who quit.

Evidence is considered strong based on findings from clinic-based trials and population-based policy evaluations of reduced out-of-pocket costs for both cessation counseling and medications. Clear communication of benefit changes to both tobacco users and healthcare providers increases use and impact of these interventions.

Results / Accomplishments

Eighteen studies were included in the review (5 from the previous review and 13 from the more recent search period). Included studies offered evidence-based treatments identified in Treating Tobacco Use and Dependence: 2008 Update (Fiore et al., 2008).

-Quit rates among tobacco users at follow-up periods of 3.5 months or longer: median absolute increase of 4.3 percentage points (interquartile interval [IQI]: 0.2 to 6.0 percentage points; 12 studies)
-Quit attempt rates: median absolute increase of 2.8 percentage points (IQI: -0.6 to 9.1 percentage points; 6 studies)
-Use of evidence-based cessation treatments among tobacco users attempting to quit: median absolute increase of 7.0 percentage points (IQI: 1.4 to 18.3 percentage points; 11 studies)
-Reductions in the prevalence of tobacco use were seen in two different populations (state employees and retirees in Wisconsin; Medicaid recipients in Massachusetts) after the provision of a new tobacco cessation benefit (2 studies).

About this Promising Practice

Primary Contact
The Community Guide
1600 Clifton Rd, NE
MS E69
Atlanta, GA 30329
(404) 498-1827
communityguide@cdc.gov
https://www.thecommunityguide.org/
Topics
Health / Alcohol & Drug Use
Source
Community Guide Branch Epidemiology and Analysis Program Office, Centers for Disease Control and Prevention
Location
USA
For more details
https://www.thecommunityguide.org/findings/tobacco...
Target Audience
Adults

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An Evidence-Based Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures showing improvement in the outcome(s) of interest after the implementation of the program (i.e. increase in smoking cessation, not just the delivery of a smoking cessation program). The outcome measure(s) is/are compared at relevant time periods before and after the intervention or program implementation. Alternatively, the evaluation study compares the outcome(s) between an intervention group and an appropriate control group.
  3. The study is of peer-review quality and presents numbers in a scientific manner; measurements of precision and reliability are included (e.g. confidence intervals, standard errors), results from statistical tests show a significant difference or change in the outcome measure(s), and relevant point estimates and p-values are presented. Note: if the results from an evaluation of a program are presented in a scientific manner and the outcome measure is improved compared to the baseline measurement or the control group but the difference is not statistically significant, the practice is classified as effective and not evidence-based.