CMS will help smokers kick the habit

BALTIMORE - Medicare's upcoming prescription drug benefit will cover smoking cessation treatments prescribed by a physician, CMS announced in late March. Researchers estimate that smoking accounts for about 10% of the total costs of the Medicare program or about $20.5 billion in 1997. On average, nonsmokers survived 1.6-3.9 years longer than those who have never smoked. "Millions of Medicare beneficiaries have smoked for many years, and are now experiencing the heart problems, respiratory problems, and many other often-fatal diseases that smoking can cause," said CMS Administrator Mark B. McClellan, M.D., Ph.D.. "It's really hard to quit, but we are going to do everything we can to help." The coverage decision, which was proposed for public comment in December, involves Medicare beneficiaries who have an illness caused or complicated by tobacco use, including heart disease, cerebrovascular disease, lung disease, weak bones, blood clots, and cataracts - the diseases that account for the bulk of Medicare spending today. It also applies to beneficiaries who take any of the many medications whose effectiveness is complicated by tobacco use - including insulins and medicines for high blood pressure, blood clots and depression. Public comments generally supported the approach that CMS proposed, although some commenters preferred broader coverage of all tobacco users. CMS modified the proposal in response to comments by removing a requirement that providers have uniform training in smoking and tobacco use cessation counseling, since no nationally accepted standards exist. When standards do become available, CMS plans to consider whether to add those requirements to its coverage policy. The Centers for Disease Control and Prevention (CDC) has estimated that 9.3% of Americans age 65 and older smoke cigarettes. About 440,000 people die annually from smoking related disease, with 300,00 of those deaths in those 65 and older. CDC estimated in 2002 that 57% of smokers age 65 and over report a desire to quit. Currently, about 10% of elderly smokers quit each year, with 1% relapsing.