Tobacco Cessation and Treatment

Greater access to tobacco cessation medications and treatment will save money and lives

A diverse coalition supports efforts to improve access to quitting help for Medical Assistance and MinnesotaCare enrollees.

All Minnesotans pay the price for tobacco’s harm

• Commercial tobacco use remains the leading cause of preventable death and disease, taking the lives of more than 6,300 Minnesotans each year.[1]
• Smoking costs the state over $7 billion a year: more than $3 billion in excess health care costs and $4 billion in lost productivity.[2] In Minnesota’s Medical Assistance program alone, smoking-related health care costs total $563 million.[3]

Smoking declines among Minnesota adults have stalled out at 14%

• An estimated 574,000 Minnesota adults still smoke and need help quitting.[4]
• Nearly half of adult smokers have a household income of $35,000 or less[5] and those enrolled in public programs are twice as likely to smoke than the general population.[6]

Barriers to treatment for tobacco dependence delay quitting and harm health

• While Medical Assistance and MinnesotaCare provide coverage for guidelines-based tobacco cessation treatment, barriers exist and change from year to year, creating confusion for providers and patients.
• The Affordable Care Act and federal regulation require quit-smoking medications to be available without cost-sharing and prior authorization requirements,[7] but some Medical Assistance and MinnesotaCare enrollees face limited, inconsistent access to these medications (i.e., only allowed two quit attempts each year).
• Another challenge is many qualified health care professionals (e.g., mental health professionals and alcohol and drug counselors) are not able to be reimbursed for delivering best practice counseling.

People living with mental illness or substance use disorders are impacted hardest by restrictive treatment policies

• People living with mental illnesses or substance use disorders are more dependent on tobacco, smoke more heavily and are more likely to die from tobacco-related illness than from their mental health or substance use conditions.[8]
• Only 40% of Minnesota’s mental health treatment facilities and 47% of substance use disorder treatment programs offer tobacco treatment counseling.[9]
• Three-quarters of adults with serious mental illness and substance use disorders want to quit smoking yet needed resources lag.
• Developing a tobacco treatment plan can take more time and may require multiple medications, higher doses, and long-term treatment options.

Removing barriers to quitting will save money and lives

• Tobacco and nicotine addiction is a chronic, relapsing condition that often requires multiple attempts to quit and repeated, individualized treatment.[10]
• Helping people quit smoking is one of the most cost-effective health services.[11] Quit-smoking help costs a fraction of what it takes to annually treat smoking related diseases such as lung cancer ($60,004[12]) and cardiovascular disease ($18,005[13]).
• Counseling and medication support can double the chances of a person successfully quitting.[14]

Minnesota can improve access to treatment for tobacco dependence by passing legislation that:

1. Requires coverage for guidelines-based tobacco cessation treatment, all FDA-approved cessation medications and group, phone, and individual counseling.
2. Requires those treatments to be available without cost-sharing and without barriers such as prior authorization requirements and quantity limits.
3. Expands the types of providers who can be reimbursed for delivering counseling services, such as alcohol and drug counselors and mental health practitioners.

For more information, view our fact sheet.